Prioleau W H, Clark S, Gross A, Voegele L D, Hairston P
Ann Thorac Surg. 1982 Nov;34(5):490-2. doi: 10.1016/s0003-4975(10)62993-1.
Flow was determined by electromagnetic flowmeter in vein bypass grafts in 20 patients with a totally occluded left anterior descending (LAD) coronary artery and on 61 patients with a partially occluded LAD. The median flow in LAD grafts was 14.5 ml/min with total LAD occlusion, and 40 ml/min with partial LAD occlusion (p less than 0.001). In cases of total LAD occlusion, the presence of mild or moderate anteroseptal wall dysfunction was associated with more satisfactory flow than was the case with severe anteroseptal wall dysfunction (p less than 0.02). Flows over 25 ml/min were found only when the LAD distal to total occlusion was 1.5 mm or greater. Unsatisfactory flows were consistently found with total LAD occlusion, poor ventricular function, and a distal LAD less than 1.5 mm. Repeat catheterizations to determine an unsatisfactory patency rate under these conditions would be necessary to alter our policy of grafting all suitable vessels beyond a total occlusion.
采用电磁流量计测定了20例左前降支（LAD）冠状动脉完全闭塞患者和61例LAD部分闭塞患者静脉搭桥血管的血流量。LAD完全闭塞患者搭桥血管的血流量中位数为14.5毫升/分钟，LAD部分闭塞患者为40毫升/分钟（p<0.001）。在LAD完全闭塞的病例中，轻度或中度前间隔壁功能障碍患者的血流量比严重前间隔壁功能障碍患者更令人满意（p<0.02）。仅当完全闭塞远端的LAD为1.5毫米或更大时，才发现血流量超过25毫升/分钟。在LAD完全闭塞、心室功能差和LAD远端小于1.5毫米的情况下，始终发现血流量不理想。在这些情况下，有必要重复进行导管插入术以确定通畅率不理想，从而改变我们对所有完全闭塞以外合适血管进行搭桥的策略。
