Barr James, Kokotsakis John, Velissarios Konstantinos, Athanasiou Thanos
Department of Cardiac Surgery, St George's Hospital, London, UK.
Department of Cardiac Surgery, Evaggelismos Hospital, Athens, Greece.
Interact Cardiovasc Thorac Surg. 2017 May 1;24(5):796-798. doi: 10.1093/icvts/ivw442.
A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether the thoracic aorta is a safe site for the proximal anastomosis when bypassing the mesenteric arteries in patients with chronic mesenteric ischaemia. Five articles reported the use of the thoracic aorta as the site of proximal anastomosis in 35 patients with chronic mesenteric ischaemia. All of these studies were retrospective case reports or case series. The ascending aorta was the site for the proximal anastomosis in 7 patients with the descending thoracic aorta being used in the other 28 patients. The ascending aorta was used when there was disease of the descending thoracic aorta. Out of the 35 patients there was only 1 perioperative death (3%). Rates of graft patency and freedom from recurrent symptoms were excellent. The published literature supports the use of the thoracic aorta as an option for the site of the proximal anastomosis when bypass from elsewhere is not possible.
一篇心血管外科的最佳证据主题文章是根据结构化方案撰写的。所探讨的问题是，在慢性肠系膜缺血患者中绕过肠系膜动脉时，胸主动脉作为近端吻合部位是否安全。五篇文章报道了35例慢性肠系膜缺血患者使用胸主动脉作为近端吻合部位的情况。所有这些研究均为回顾性病例报告或病例系列。7例患者的近端吻合部位为升主动脉，另外28例患者使用降主动脉。当降胸主动脉存在病变时使用升主动脉。35例患者中仅有1例围手术期死亡（3%）。移植物通畅率和无复发症状率都很好。已发表的文献支持在无法从其他部位进行旁路移植时，将胸主动脉作为近端吻合部位的一个选择。
