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[使用乳内动脉移植物和大隐静脉移植物进行主动脉冠状动脉搭桥手术的比较研究]

[Comparative study of aorto-coronary bypass surgery using internal mammary artery grafts and saphenous vein grafts].

作者信息

Moriya H, Yasuura K, Okamoto H, Matsuura A, Akita T, Watanabe T, Takeuchi E, Tanaka M, Abe T, Seki A

机构信息

Department of Thoracic Surgery, Nagoya University School of Medicine.

出版信息

Kyobu Geka. 1990 Jan;43(1):13-8.

PMID:2304292
Abstract

From April, 1985, through March, 1988, 202 patients had aorto-coronary artery bypass (CABG). In two series of consecutive patients who underwent CABG alone with the saphenous vein (SVG) or the internal mammary artery (IMA), mortality, morbidity and postoperative angiographic findings were compared with two series. The mean number of grafts placed was 1.8 per patient (1 to 4 grafts) in IMA group and 2.2 per patient (1 to 4 grafts) in SVG group. Mortality was 3% in two groups. The intraoperatively mean blood flow of graft to LAD in SVG and the mean blood flow of free end of IMA had no significant difference. The early patency rate (1.5 months) was 96% for 177 grafts in IMA group, 97% for 100 with IMA-LAD anastomosis, and 95% for 221 grafts in SVG group, 97.7% for 88 with SVG-LAD anastomosis. Morbidity was not significantly different. Many reports suggested that the long-term patency rate was good within the IMAG. In conclusion, the usefulness of IMAG in Japanese patients should be more stressed in young patients.

摘要

从1985年4月至1988年3月,202例患者接受了主动脉冠状动脉搭桥术(CABG)。在两组分别单独使用大隐静脉(SVG)或乳内动脉(IMA)进行CABG的连续患者中,对死亡率、发病率和术后血管造影结果进行了比较。IMA组每位患者植入的移植物平均数量为1.8个(1至4个移植物),SVG组每位患者为2.2个(1至4个移植物)。两组的死亡率均为3%。SVG组移植物至左前降支(LAD)的术中平均血流量与IMA游离端的平均血流量无显著差异。IMA组177个移植物的早期通畅率(1.5个月)为96%,IMA-LAD吻合的100个移植物为97%,SVG组221个移植物为95%,SVG-LAD吻合的88个移植物为97.7%。发病率无显著差异。许多报告表明,IMA桥内长期通畅率良好。总之,在日本患者中,IMA桥在年轻患者中的有用性应得到更多强调。

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