Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Ann Cardiothorac Surg. 2013 Jul;2(4):427-30. doi: 10.3978/j.issn.2225-319X.2013.07.21.
For over a decade there has been accumulating evidence that the use of more than a single arterial graft during coronary artery bypass grafting can improve clinical outcomes. However the vast majority of patients in most developed countries still only receive a single arterial conduit even in the presence of multivessel coronary artery disease. This review summarizes the current evidence for the use of a second internal mammary artery and/or radial artery graft. While in comparison to vein grafts the superior patency of internal mammary artery grafts is well established, there now exists strong and consistent evidence of the superior patency of radial arteries over the longer term. Likewise, there is a rapidly growing body of evidence that the superior patency of both these arteries in comparison to vein grafts translates into improved clinical outcomes.
十多年来，越来越多的证据表明，在冠状动脉旁路移植术中使用超过一根动脉移植物可以改善临床结果。然而，在大多数发达国家，即使存在多支冠状动脉疾病，绝大多数患者仍然只接受单一的动脉导管。这篇综述总结了使用第二根乳内动脉和/或桡动脉移植物的现有证据。虽然与静脉移植物相比，乳内动脉移植物的通畅性明显更好，但现在有强有力且一致的证据表明，桡动脉的长期通畅性优于静脉移植物。同样，越来越多的证据表明，与静脉移植物相比，这两种动脉的通畅性更好，可转化为临床结果的改善。
