Yim Daniel, Wong Wing Yan E, Fan Ka Siu, Harky Amer
School of Medicine, St. George's Medical School, University of London, London, UK.
School of Medicine, Brighton and Sussex Medical School, University of Sussex, East Sussex, UK.
J Card Surg. 2020 Apr;35(4):860-867. doi: 10.1111/jocs.14459. Epub 2020 Feb 14.
Coronary artery bypass graft (CABG) is one of the most commonly performed cardiac surgeries in the world. CABG using the internal mammary artery (IMA) remains the gold standard intervention for myocardial intervention in multivessel coronary artery disease. IMA harvesting can be performed with various techniques and approaches: pedicled vs skeletonized harvesting technique as well as approaches such as conventional sternotomy, robotic and endoscopic approaches. While each technique and approach have their respective advantages and disadvantages, evidence remains varied between cohorts. Traditionally, IMA has been used as an in situ conduit; however, IMA free grafts also provide satisfactory outcomes in certain situations. This literature review aims to explore the efficacy of different techniques and approaches of IMA harvesting and grafting. With evidence compiled, this will provide an overview of the complexity of CABG and locate gaps in current literature to direct future research.
冠状动脉搭桥术（CABG）是世界上最常见的心脏手术之一。使用乳内动脉（IMA）的CABG仍然是多支冠状动脉疾病心肌干预的金标准干预措施。IMA获取可以通过多种技术和方法进行：带蒂与骨骼化获取技术以及传统胸骨切开术、机器人手术和内镜手术等方法。虽然每种技术和方法都有其各自的优缺点，但不同队列之间的证据仍然存在差异。传统上，IMA一直被用作原位血管；然而，IMA游离移植物在某些情况下也能提供令人满意的结果。这篇文献综述旨在探讨IMA获取和移植的不同技术和方法的疗效。通过收集证据，这将概述CABG的复杂性，并找出当前文献中的空白以指导未来的研究。
