Gharibeh Lara, Ferrari Giovanni, Ouimet Mireille, Grau Juan B
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
JACC Basic Transl Sci. 2021 Apr 27;6(4):388-396. doi: 10.1016/j.jacbts.2020.11.015. eCollection 2021 Apr.
Coronary artery bypass graft (CABG) is the gold standard for coronary surgical revascularization. Retrospective, prospective, and meta-analysis studies looking into long-term outcomes of using different conduits have pointed to the superiority of arterial grafts over veins and have placed the internal mammary artery as the standard conduit of choice for CABG. The superiority of the internal mammary artery over other conduits could be attributable to its intrinsic characteristics; however, little is known regarding the features that render some conduits atherosclerosis-prone and others atherosclerosis-resistant. Here, an overview is provided of the available data on the most commonly used conduits in CABG (internal mammary artery, saphenous vein, radial artery, gastroepiploic artery), highlighting the differences in their cellular biology, mechanical, biochemical, and vasoconstrictive properties. This information should help in furthering our understanding of the clinical outcomes observed for each of these conduits.
冠状动脉旁路移植术（CABG）是冠状动脉外科血运重建的金标准。回顾性、前瞻性及荟萃分析研究对使用不同血管移植物的长期结果进行了探究，结果表明动脉移植物优于静脉移植物，并将乳内动脉列为CABG的标准首选血管移植物。乳内动脉相较于其他血管移植物的优越性可能归因于其内在特性；然而，对于使某些血管移植物易于发生动脉粥样硬化而另一些具有抗动脉粥样硬化能力的特征，我们却知之甚少。在此，本文对CABG中最常用的血管移植物（乳内动脉、大隐静脉、桡动脉、胃网膜动脉）的现有数据进行了概述，突出了它们在细胞生物学、机械、生化及血管收缩特性方面的差异。这些信息应有助于加深我们对这些血管移植物各自临床结果的理解。
