Loop F D, Carabajal N R, Taylor P C, Irarrazaval M J
Am J Cardiol. 1976 May;37(6):890-5. doi: 10.1016/0002-9149(76)90115-6.
Thirty-two consecutive patients who earlier received indirect or direct myocardial revascularization underwent reoperation with one or more internal mammary artery grafts either alone or in combination with saphenous vein grafts. The main indication for reoperation was graft closure or progression of coronary atherosclerosis in nongrafted vessels, or both. Graft construction was performed under normothermic perfusion and anoxic arrest with interrupted suture technique. No intraoperative infarctions or hospital deaths occurred. All patients are alive after an average follow-up period of 20 months, and two thirds are asymptomatic. Arteriography after reoperation in nine patients revealed patency of eight of nine internal mammary artery and five of five secondary vein grafts. When angiographic and symptomatic indications for reoperation exist, the internal mammary artery bypass graft has become a valuable alternative, particularly for patients with small coronary vessels or previous vein graft failure.
32例先前接受过间接或直接心肌血运重建的患者接受了再次手术，使用一根或多根乳内动脉移植物，单独使用或与大隐静脉移植物联合使用。再次手术的主要指征是移植物闭塞或非移植血管中冠状动脉粥样硬化进展，或两者皆有。移植物构建在常温灌注和缺氧停搏下采用间断缝合技术进行。术中无梗死或医院死亡发生。所有患者在平均20个月的随访期后均存活，三分之二无症状。9例患者再次手术后的血管造影显示，9根乳内动脉中有8根通畅，5根二级静脉移植物中有5根通畅。当存在再次手术的血管造影和症状指征时，乳内动脉旁路移植已成为一种有价值的选择，特别是对于冠状动脉血管细小或先前静脉移植物失败的患者。
