Donzeau-Gouge P, Touati G, Vouhe P, Roy A, Farge C, Leca F, Neveux J Y
Unité de Chirurgie Thoracique et Cardio-vasculaire, Clinique du Bois de Verrières, Antony.
Ann Chir. 1990;44(8):599-601.
Among 760 patients who underwent coronary artery bypass graft (CABG) 8 received one or two bovine internal mammary artery grafts. The surgical procedures were 4, 3 and 3 CABG respectively in 1, 3 and 4 cases with greater saphenous veins in 4 cases, internal mammary artery in 4 cases and bovine internal mammary artery in 11 cases. The 3 mm bioflow grafts were used to revascularize the left coronary artery in 6 cases (to the left anterior descending, circumflex artery) and the right coronary artery in 5 cases. The indications for the use of bovine mammary artery grafts were lack of suitable autologous vessels because of bilateral saphenous vein stripping in 4 cases, bilateral varicose veins in 3 cases and inadequate length of vein in 1 case. Post-operative angiographic studies of these bovine mammary grafts with a maximum follow-up of 11 months showed 5 occluded grafts, 2 grafts with proximal stenosis, one graft which remained patent until the patient died and 3 grafts still under evaluation. Bovine internal mammary artery grafts provide a solution for the acute stage of coronary disease, but do not achieve total and durable revascularization. Their use must remain exceptional.
在760例行冠状动脉旁路移植术(CABG)的患者中,8例接受了1根或2根牛的胸廓内动脉移植。手术过程中,分别有1例、3例和4例患者行4、3和3次CABG,其中4例使用大隐静脉,4例使用胸廓内动脉,11例使用牛的胸廓内动脉。使用3毫米生物流移植物对6例患者的左冠状动脉(左前降支、回旋支)和5例患者的右冠状动脉进行血运重建。使用牛胸廓内动脉移植物的指征包括:4例因双侧大隐静脉剥脱而缺乏合适的自体血管,3例双侧静脉曲张,1例静脉长度不足。对这些牛胸廓内动脉移植物进行的术后血管造影研究,最长随访11个月,结果显示5根移植物闭塞,2根移植物近端狭窄,1根移植物在患者死亡前仍保持通畅,3根移植物仍在评估中。牛胸廓内动脉移植物为冠心病急性期提供了一种解决方案,但不能实现完全持久的血运重建。其使用必须保持例外情况。