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冠状动脉搭桥手术中序贯静脉移植与单支静脉移植的通畅率

Patency of sequential versus single vein grafts in coronary bypass surgery.

作者信息

Meurala H, Valle M, Hekali P, Somer K, Frick M H, Harjola P T

出版信息

Thorac Cardiovasc Surg. 1982 Jun;30(3):147-51. doi: 10.1055/s-2007-1022233.

Abstract

The patency and graft flow of sequential (seq. SVBG) and single saphenous vein bypass grafts (single SVBG) in coronary bypass surgery were compared angiographically (mean follow-up 26 months) in 76 patients with 36 seq. SVBG (75 distal anastomoses) and 85 single SVBGs. The late patency of all seq. SVBGs anastomoses (94.7%) was higher than that of single SVBGs (80.0%). No early or late graft occlusions were seen in the side-to-side (SSA) anastomoses of the seq. SVBGs. The cine-angiographically determined mean volume flow in the proximal segments of the seq. SVBGs was significantly higher (p less than 0.001) than that in the distal segments of the seq. SVBGs or in the single SVBGs at both early and late follow-up. Despite the higher late patency rate (88.9% vs 80.0%) in the end-to-side anastomoses (ESA) of the seq SVBGs, the mean graft flow was significantly lower in the distal segments of seq SVBGs than in the single SVBGs (71 ml/min vs. 109 ml/min, p less than 0.05).

摘要

对76例患者的36条序贯式大隐静脉搭桥术(seq. SVBG)和85条单条大隐静脉搭桥术(single SVBG)在冠状动脉搭桥手术中的通畅情况及移植血管血流进行了血管造影比较(平均随访26个月),其中序贯式搭桥有75个远端吻合口。所有序贯式搭桥吻合口的晚期通畅率(94.7%)高于单条大隐静脉搭桥(80.0%)。序贯式搭桥的侧侧吻合(SSA)未出现早期或晚期移植血管闭塞。血管造影电影测定的序贯式搭桥近端节段平均血流量在早期和晚期随访时均显著高于序贯式搭桥远端节段或单条大隐静脉搭桥(p<0.001)。尽管序贯式搭桥的端端吻合(ESA)晚期通畅率较高(88.9%对80.0%),但序贯式搭桥远端节段的平均移植血管血流量显著低于单条大隐静脉搭桥(71毫升/分钟对109毫升/分钟,p<0.05)。

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