Angell W W, Sywak A
Circulation. 1977 Sep;56(3 Suppl):II22-5.
Controversy persists as regards the efficacy of aortocoronary saphenous vein bypass graft (SVBG) compared to direct internal mammary artery (IMA) anastomosis. In general, the IMA graft (IMAG) is considered to be superior as regards postoperative patency. To avoid preselection bias, 74 consecutive, unselected patients with bypassable lesions of the left anterior descending artery (LAD) were randomized to undergo either SVBG or IMAG to the LAD in 1972-1974. The majority of patients had, in addition, SVBGs to other vessels. Postoperative angiograms, an average of 6 months after surgery, were obtained in two-thirds of the patients. The following observations were made: (formula: see text). In this series there is no clear advantage of the IMAG over the SVBG. The preparation of the internal mammary artery for grafting is tedious and the anastomosis more difficult to perform. The resultant flow in the internal mammary artery graft is less overall than in the SVBG. In over 400 unselected SVBGs to the LAD that have been restudied thus far in our practice, an 86% patency rate has been achieved.
与直接的胸廓内动脉（IMA）吻合相比，主动脉冠状动脉大隐静脉旁路移植术（SVBG）的疗效仍存在争议。一般来说，就术后通畅率而言，胸廓内动脉移植物（IMAG）被认为更具优势。为避免预先选择偏倚，1972年至1974年间，74例连续的、未经选择的左前降支（LAD）可旁路病变患者被随机分为两组，分别接受LAD的SVBG或IMAG。此外，大多数患者还接受了其他血管的SVBG。三分之二的患者在术后平均6个月时进行了血管造影。得出以下观察结果：（公式：见正文）。在本系列中，IMAG相对于SVBG没有明显优势。用于移植的胸廓内动脉的制备繁琐，吻合操作更困难。胸廓内动脉移植物的总体血流量低于SVBG。在我们目前的实践中，对400多条未经选择的LAD的SVBG进行复查，通畅率达到了86%。
