Suma H, Oku T, Sato H, Koike R, Sawada Y, Takeuchi A
Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jan;38(1):140-5.
Free arterial graft of the internal mammary artery (IMA) and the gastroepiploic artery (GEA) has been utilized for coronary artery bypass grafting in 10 patients during 44 months period. There were 6 males and 4 females and age ranged 42 to 73 year old with the mean of 60.8 year old. Eight IMA and 2 GEA were used as a free graft. Sites of distal anastomosis of the free graft were 3 at anterior descending arteries, 3 at diagonal branches and 4 at circumflex arteries. Sites of proximal anastomosis of those grafts were ascending aorta in one, concomitantly utilized saphenous vein graft in 5 and in situ IMA graft in 4 patients. Mean number of grafts was 2.9 (2-5) and mean aortic cross clamp time was 56.2 minutes (16-90 minutes). There was neither operative death, nor perioperative myocardial infarction and intra-aortic balloon pumping was not required. Postoperative angiography was made in 9 patients within 3 postoperative months. Eight (89%) free arterial grafts were patent. Relief of angina was obtained in all patients. We concluded that the complete revascularization with only arterial graft can be achieved more widely by utilizing the free arterial graft with an acceptable patency.
在44个月期间，对10例患者采用了游离胸廓内动脉（IMA）和胃网膜动脉（GEA）进行冠状动脉旁路移植术。其中男性6例，女性4例，年龄42至73岁，平均60.8岁。使用了8根IMA和2根GEA作为游离移植物。游离移植物远端吻合部位在前降支动脉3处、对角支动脉3处、回旋支动脉4处。这些移植物近端吻合部位，1例在升主动脉，5例同时使用了大隐静脉移植物，4例使用了原位IMA移植物。平均移植血管数为2.9根（2至5根），平均主动脉阻断时间为56.2分钟（16至90分钟）。既无手术死亡，也无围手术期心肌梗死，且无需主动脉内球囊反搏。9例患者在术后3个月内进行了术后血管造影。8根（89%）游离动脉移植物通畅。所有患者心绞痛均得到缓解。我们得出结论，通过使用具有可接受通畅率的游离动脉移植物，可以更广泛地仅采用动脉移植物实现完全血运重建。
