Kitamura Tadashi, Motomura Noboru, Higashikuni Yasutomi, Ono Minoru
Department of Cardiothoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Interact Cardiovasc Thorac Surg. 2011 Dec;13(6):679-81. doi: 10.1510/icvts.2011.280537. Epub 2011 Sep 4.
Radial artery conduits have recently been used more often in coronary artery bypass grafting because of their potentially better long-term patency than saphenous vein conduits. However, vasospasm of the radial artery conduit due to its nature as a muscular artery has always been of concern and a variety of vasodilators have empirically been used to reduce the risk of spasm. When a patient who was preoperatively taking antihypertensive agents undergoes coronary artery bypass using a radial artery graft, and if he/she is not hypertensive postoperatively, it is not always easy to decide what medication to start with. We report a case of a patient with a radial artery graft who did not receive vasodilators after surgery due to hypotension. The patient developed vasospasm of the radial artery conduit which did not respond to direct injection of vasodilators into the conduit but recovered after taking oral vasodilators for four weeks.
由于桡动脉桥血管在长期通畅性方面可能优于大隐静脉桥血管，近年来在冠状动脉旁路移植术中的应用越来越频繁。然而，由于桡动脉桥血管作为肌性动脉的特性，其血管痉挛一直备受关注，各种血管扩张剂已被经验性地用于降低痉挛风险。当术前服用抗高血压药物的患者使用桡动脉移植物进行冠状动脉旁路移植术时，如果术后血压不高，并不总是容易决定开始使用何种药物。我们报告一例使用桡动脉移植物的患者，术后因低血压未接受血管扩张剂治疗。该患者发生了桡动脉桥血管痉挛，向桥血管内直接注射血管扩张剂无效，但口服血管扩张剂四周后恢复。
