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冠状动脉旁路移植手术中动脉移植物的抗痉挛处理

Antispastic Management in Arterial Grafts in Coronary Artery Bypass Grafting Surgery.

作者信息

He Guo-Wei, Taggart David P

机构信息

Department of Cardiovascular Surgery and Center for Basic Medical Research, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin and Zhejiang University and The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China, and Department of Surgery, Oregon Health and Science University, Portland, Oregon.

Department of Cardiothoracic Surgery, Oxford University, United Kingdom.

出版信息

Ann Thorac Surg. 2016 Aug;102(2):659-68. doi: 10.1016/j.athoracsur.2016.03.017. Epub 2016 Jun 17.

Abstract

Arterial grafts have long-term patency superior to vein grafts but have a tendency to develop spasm that can lead to potentially life-threatening complications. A perfect antispastic protocol should include advanced surgical technique and adequate pharmacologic methods. All pharmacologic vasodilator drugs relax the vessel through specific mechanisms, and therefore, there is no perfect, single best vasodilator to prevent or treat spasm of the arterial graft against all mechanisms of contraction. One of the choices is to use a combination of pharmacologic vasodilators targeting different mechanisms of spasm to obtain the reliable and best effect.

摘要

动脉移植物的长期通畅性优于静脉移植物,但有发生痉挛的倾向,这可能导致潜在的危及生命的并发症。一个完善的抗痉挛方案应包括先进的手术技术和适当的药物方法。所有的血管扩张药物都通过特定机制使血管松弛,因此,不存在一种完美的、单一的最佳血管扩张剂能针对动脉移植物痉挛的所有收缩机制进行预防或治疗。一种选择是联合使用针对不同痉挛机制的血管扩张药物,以获得可靠且最佳的效果。

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