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[静脉主动脉冠状动脉搭桥术后一年的通透性]

[Permeability of venous aortocoronary bypasses one year after their implantation].

作者信息

Benacerraf A, Scholl J M, Bercovici P, Tonnelier M, Morin B, Charlier P, Estève C, Vasselin M, de Langenhagen B

出版信息

Arch Mal Coeur Vaiss. 1987 May;80(5):620-6.

PMID:3113380
Abstract

For a short-term evaluation of the patency of aortocoronary bypass vein grafts, 54 consecutive patients who underwent this operation alone were examined, irrespective of their functional state, 12.4 +/- 2.1 months after surgery. Examinations included coronary arteriography, selective opacification of the graft and ventriculography. The patients were 47 men and 7 women who had coronary arteriography for stable angina pectoris (22.4%) or a recent episode of unstable angina (59.3%) or a recent myocardial infarction (18.5%). Coronary arteriography showed one-vessel (5.5%), two-vessel (27.8%) or three-vessel (42.6) disease or stenosis of the main left coronary artery (24.1%). The mean number of distal anastomoses in multiple-vessel patients was 2.6. Peri-operative mortality was 1.04%, and the proportion of peri-operative electrocardiographic signs of necrosis was 11%. At the time of control examination, 82% of the patients had few or no symptoms, and 88% were improved by at least one functional class. 79% (97/123) of distal venous anastomoses were patent. All anastomoses were patent in 59% (22/54) and all were occluded in 7% (4/54) of the patients. Localized stenosis of the graft was found in 11% and diffuse stenosis in 4% of the cases. The patency of vein grafts was higher when the distal bed was of normal size than when it was small or poorly visualized at the initial angiography (85% vs 62%, p less than 0.01), or when the diameter of the artery bypassed was greater than 1.3 mm.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了对主动脉冠状动脉搭桥静脉移植物的通畅情况进行短期评估,我们对54例仅接受了该手术的连续患者进行了检查,不论其功能状态如何,检查时间为术后12.4±2.1个月。检查包括冠状动脉造影、移植物选择性显影和心室造影。患者中有47名男性和7名女性,因稳定型心绞痛(22.4%)、近期不稳定型心绞痛发作(59.3%)或近期心肌梗死(18.5%)接受冠状动脉造影。冠状动脉造影显示单支血管病变(5.5%)、双支血管病变(27.8%)或三支血管病变(42.6%)或左冠状动脉主干狭窄(24.1%)。多支血管病变患者的远端吻合口平均数量为2.6个。围手术期死亡率为1.04%,围手术期心电图坏死征象的比例为11%。在对照检查时,82%的患者症状很少或无症状,88%的患者功能分级至少提高了一级。79%(97/123)的远端静脉吻合口通畅。59%(22/54)的患者所有吻合口均通畅,7%(4/54)的患者所有吻合口均闭塞。11%的病例发现移植物局部狭窄,4%的病例发现弥漫性狭窄。当远端床在初始血管造影时大小正常时,静脉移植物的通畅率高于远端床较小或显影不佳时(85%对62%,p<0.01),或者当被绕过的动脉直径大于1.3mm时。(摘要截取自250字)

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