Neitzel G F, Barboriak J J, Pintar K, Qureshi I
Arteriosclerosis. 1986 Nov-Dec;6(6):594-600. doi: 10.1161/01.atv.6.6.594.
Segments of aortocoronary vein grafts from a selective group of 42 patients who underwent a second revascularization procedure or came to autopsy 6 to 12 years after coronary bypass surgery were studied. Complex atheromata often associated with an acute thrombus were present in 71% of the grafts. In 14% of the cases, aneurysms of the atherosclerotic type were noted. The medical records of 40 of these patients were reviewed. Special attention was paid to risk factors associated with coronary artery disease. A control population of 535 patients who had undergone coronary artery bypass surgery and had not had recurrence of symptoms requiring reoperation 5 or more years later was drawn from the Milwaukee Cardiovascular Data Registry. Significantly higher triglyceride and cholesterol levels and lower high density lipoprotein levels were noted in the patients undergoing two bypass procedures. In addition more diabetics, cigarette smokers, and patients with abnormal lipoprotein phenotypes were noted in the study group. Hypertension did not appear to be a significant risk factor. Atherosclerosis appears to be an important factor in late graft failure. Vein grafts that develop atherosclerosis appear to be susceptible to aneurysm formation. Risk factors associated with atherosclerosis in coronary arteries also appear to play a role in the development of atherosclerosis in aortocoronary bypass grafts.
对42例接受二次血运重建手术或在冠状动脉搭桥手术后6至12年进行尸检的特定患者的主动脉冠状动脉静脉移植物节段进行了研究。71%的移植物中存在常伴有急性血栓的复杂动脉粥样斑块。在14%的病例中，发现了动脉粥样硬化型动脉瘤。对其中40例患者的病历进行了回顾。特别关注了与冠状动脉疾病相关的危险因素。从密尔沃基心血管数据登记处选取了535例接受冠状动脉搭桥手术且5年或更长时间后未出现需要再次手术的症状复发的患者作为对照人群。接受两次搭桥手术的患者甘油三酯和胆固醇水平显著更高，高密度脂蛋白水平更低。此外，研究组中糖尿病患者、吸烟者和脂蛋白表型异常的患者更多。高血压似乎不是一个显著的危险因素。动脉粥样硬化似乎是晚期移植物失败的一个重要因素。发生动脉粥样硬化的静脉移植物似乎易发生动脉瘤形成。与冠状动脉粥样硬化相关的危险因素似乎也在主动脉冠状动脉搭桥移植物动脉粥样硬化的发展中起作用。
