Singh R N
Cathet Cardiovasc Diagn. 1980;6(4):439-49. doi: 10.1002/ccd.1810060414.
A technique for catheterization of both internal mammary arteries (IMAs) by right brachial approach is described. A special preformed catheter was used in 75 patients with coronary artery disease, including ten patients with direct IMA grafts. No complications occurred. The IMAs were studied to examine the question of their usefulness in direct myocardial revascularization. There were individual variations in the size of IMAS with poor correlation to age (r = -0.432)) and body surface area (r = 0.517). Seventy percent of the women had adequate IMAs. The IMA diameter was equal to or larger than the left anterior descending coronary artery (LAD) in 72% and the right coronary artery (RCA) in 34% of comparisons. Of the ten patients with direct IMA grafts, three instances of large side branches were seen. These branches appeared to carry large flows at the expense of the grafted coronary artery. Preoperative internal mammary arteriography should be done if the use of this vessel is contemplated in direct myocardial revascularization to assure the use of an IMA of adequate caliber compared to the recipient coronary artery. The side branches should be meticulously ligated during the operation.
描述了一种经右肱动脉途径对双侧乳内动脉（IMA）进行插管的技术。在75例冠心病患者中使用了一种特殊的预制导管，其中包括10例直接进行IMA移植的患者。未发生并发症。对IMA进行研究以探讨其在直接心肌血运重建中的实用性问题。IMA的大小存在个体差异，与年龄（r = -0.432）和体表面积（r = 0.517）的相关性较差。70%的女性有足够的IMA。在72%的比较中，IMA直径等于或大于左冠状动脉前降支（LAD），在34%的比较中等于或大于右冠状动脉（RCA）。在10例直接进行IMA移植的患者中，发现3例有大的侧支。这些侧支似乎以牺牲移植的冠状动脉为代价携带大量血流。如果考虑在直接心肌血运重建中使用该血管，术前应进行乳内动脉造影，以确保与受体冠状动脉相比使用口径合适的IMA。手术期间应仔细结扎侧支。
