Fukumoto H, Suma H, Kondo K, Kimura H, Hasegawa S, Takeuchi A
Department of Thoracic Surgery, Osaka Medical College, Takatsuki, Japan.
Nihon Geka Gakkai Zasshi. 1988 Jun;89(6):938-44.
From November, 1984, to February 1987, internal mammary artery (IMA) and gastroepiploic artery (GEA) graftings to coronary arteries were performed in 65 patients. Of these patients, 58 unilateral IMAs, 6 bilateral IMAs, 2 GEAs were utilized. The hospital mortality was 3.2% but no cardiogenic death occurred. Fifty-eight (89%) patients became asymptomatic after surgery. Postoperative angiography performed from 1 to 3 months after operation showed excellent patency in 57 (96%) IMAs and 2 (100%) GEAs. On the other hand, the patency of saphenous vein graft done at the same period were 88%. GEAs were used for 2 reoperated cases and revealed good patency and relief of symptoms without surgical complication. Cavitron ultrasonic surgical aspirator (CUSA) was used to dissect IMA from the chest wall, which was useful to shorten the operative time. In conclusion, arterial grafts, such as IMA and GEA were thought to be excellent coronary bypass conduits even for the small Japanese patient.
1984年11月至1987年2月,对65例患者进行了冠状动脉内乳动脉(IMA)和胃网膜动脉(GEA)移植术。在这些患者中,使用了58根单侧IMA、6根双侧IMA、2根GEA。医院死亡率为3.2%,但未发生心源性死亡。58例(89%)患者术后无症状。术后1至3个月进行的血管造影显示,57根(96%)IMA和2根(100%)GEA通畅良好。另一方面,同期进行的大隐静脉移植通畅率为88%。GEA用于2例再次手术的病例,显示通畅良好且症状缓解,无手术并发症。使用Cavitron超声手术吸引器(CUSA)从胸壁分离IMA,这有助于缩短手术时间。总之,即使对于身材矮小的日本患者,IMA和GEA等动脉移植物也被认为是优良的冠状动脉搭桥管道。