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原位大隐静脉移植吻合口和移植血管形态对冠状动脉旁路移植术后静脉桥长期通畅率的影响。

Influence of graft anastomosis and graft morphology on long-term patency of the saphenous vein after aortocoronary bypass.

机构信息

Department of Cardiac Surgery, University Hospital Ostrava, Ostrava, Czech Republic.

Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024 Sep;168(3):223-228. doi: 10.5507/bp.2024.013. Epub 2024 Apr 24.

Abstract

OBJECTIVE

Several factors are involved in the preservation of graft function after surgical myocardial revascularization. This follow-up study aimed to evaluate the effects of vein graft anastomosis and graft morphology on long-term graft patency a minimum of 10 years after aortocoronary bypass grafting.Setting and Cohorts. This was a sub-analysis of a study that enrolled patients after isolated bypass surgery at the University Hospital Ostrava in order to evaluate the long-term graft patency of the saphenous vein after endoscopic harvest, a minimum of 10 years after aortocoronary bypass grafting.

METHODS

Fifty angiograms, with a total of 90 grafts, after isolated myocardial revascularization were visualized using coronary computed tomography angiography, with 50% luminal stenosis or greater considered significant.

RESULTS

The overall graft patency rate was 72.3%. The differences in occlusion rates between sequential and individual grafts were not statistically significant (P=0.156). All y-grafts were totally occluded. Graft and target artery diameters had a statistically significant influence on patency (P=1.000 and 0.381, respectively). Longer graft length and higher calcium scores were associated with statistically significant graft occlusion (P=0.033 and 0.005, respectively).

CONCLUSION

Sequential grafts can be constructed safely, especially when the goal is complete myocardial revascularization.

摘要

目的

在外科心肌血运重建后,有几个因素涉及移植物功能的保存。这项随访研究旨在评估静脉移植物吻合和移植物形态对经皮冠状动脉旁路移植术(CABG)后至少 10 年的长期移植物通畅性的影响。

背景和队列

这是对在奥斯特拉瓦大学医院进行单纯旁路手术后入组患者进行的一项研究的亚分析,目的是评估内窥镜采集的隐静脉在经皮冠状动脉旁路移植术(CABG)后至少 10 年的长期通畅情况。

方法

使用冠状动脉计算机断层血管造影术对 50 例孤立性心肌血运重建后的 50 个血管造影术和 90 个移植物进行可视化检查,认为管腔狭窄 50%或以上具有显著意义。

结果

总体移植物通畅率为 72.3%。序贯和单个移植物之间的闭塞率差异无统计学意义(P=0.156)。所有 Y 型移植物均完全闭塞。移植物和靶动脉直径对通畅性有统计学意义(P=1.000 和 0.381)。较长的移植物长度和较高的钙评分与移植物闭塞有统计学意义(P=0.033 和 0.005)。

结论

序贯移植物可以安全构建,尤其是当目标是完全血运重建时。

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