Huttunen H, Huttunen K, Tuppurainen T, Soimakallio S, Suhonen M, Länsimies E, Rautio P, Kuikka J, Rehnberg S
Department of Thoracic, Kuopio University Central Hospital, Finland.
Scand J Thorac Cardiovasc Surg. 1989;23(1):13-8. doi: 10.3109/14017438909105960.
Reversed left internal mammary artery grafting with retrograde flow to the left anterior descending coronary branch was used in five of 500 consecutive bypass operations. The indications were significant stenosis in the left subclavian artery (3 patients) or the proximal left internal mammary artery (1) and proximal damage to the left internal mammary artery during dissection from the thoracic wall (1). The postoperative clinical course was smooth in all five patients, with no evidence of myocardial ischemia. In follow-up averaging 14 months four patients were asymptomatic. The reversed internal mammary artery graft was visualized with digital subtraction angiography in four cases. Radionuclide imaging during exercise confirmed graft patency in all but the symptomatic patient, who was found to have an area of reversible ischemia anteriorly in the left ventricle.
在连续500例搭桥手术中，有5例采用了左乳内动脉逆行血流移植至左前降支冠状动脉分支。适应证为左锁骨下动脉严重狭窄（3例）或左乳内动脉近端狭窄（1例），以及在从胸壁游离时左乳内动脉近端受损（1例）。所有5例患者术后临床过程顺利，无心肌缺血证据。平均随访14个月时，4例患者无症状。4例通过数字减影血管造影显示了逆行乳内动脉移植血管。运动时的放射性核素成像证实，除有症状的患者外，其他患者的移植血管均通畅，该有症状患者左心室前壁有可逆性缺血区。
