Schulte H D, Bircks W, Loogen F, Rivas-Martin J, Spiller P
Thoraxchir Vask Chir. 1978 Aug;26(4):266-9. doi: 10.1055/s-0028-1096635.
In a series of 432 aortocoronary bypass procedures endarterectomies were performed in 58 patients (13.4%) on 60 coronary arteries. Except of two vein patch grafts all endarterectomized arteries were bypassed with a saphenous vein graft. The majority of the patients had an endarterectomy of the right coronary artery. Clinical control investigations were performed in 43 out of 47 survivors including 30 with coronary angiograms 5.2 months (mean) after surgery. 26 out of 31 endarterectomized arteries (83.9%) were open angiographically whereas the patency rate to non-endarterectomized arteries of the same patients was 86.4%. The hospital mortality was high; 11 out of 58 patients (19%) deceased. All patients who died postoperatively had a three vessel disease with diffuse coronary sclerosis. Only three had no myodardial infarction prior to surgery, seven had one to four infarctions before surgery. The relatively high mortality intends for the future a more strict revision of the indications for coronary surgical procedures. But not in all cases the preoperative coronary angiograms and ventriculograms allow a clear estimation of the local arterial conditions.
在432例主动脉冠状动脉搭桥手术系列中，58例患者（13.4%）的60条冠状动脉进行了内膜切除术。除了两个静脉补片移植外，所有接受内膜切除术的动脉均用大隐静脉移植进行搭桥。大多数患者接受了右冠状动脉内膜切除术。对47名幸存者中的43名进行了临床对照研究，包括30名在术后5.2个月（平均）进行冠状动脉造影的患者。31条接受内膜切除术的动脉中有26条（83.9%）在血管造影上显示通畅，而同一患者未接受内膜切除术的动脉通畅率为86.4%。医院死亡率较高；58例患者中有11例（19%）死亡。所有术后死亡的患者均患有三支血管疾病伴弥漫性冠状动脉硬化。术前只有3例没有心肌梗死，7例术前有1至4次梗死。相对较高的死亡率意味着未来需要对冠状动脉手术的适应症进行更严格的修订。但并非所有情况下，术前冠状动脉造影和心室造影都能清楚地评估局部动脉状况。
