Ullyot D J, Turley K, McKay C R, Brundage B H, Lipton M J, Ebert P A
J Thorac Cardiovasc Surg. 1982 Apr;83(4):512-8.
Early saphenous vein coronary bypass graft patency has been found to range from 82% to 94%. Recent advances in computed tomography have led to the development of a safe, effective, and "relatively noninvasive" means of assessing early graft patency. We designed a prospective study using contrast-enhanced computed tomography (CECT), postulating that selected grafts might be redone prior to the development of pericardial adhesions if early closure was demonstrated. Forty-three random patients undergoing elective coronary artery bypass comprise the study group. All patients underwent CECT study of graft patency an average of 6 days postoperatively (range 1 to 17 days). Ninety of 96 grafts were open, for an early patency rate of 94%. Three of the grafts were closed because of poor run-off or extensive distal coronary atherosclerosis. Two additional grafts were closed, one in a patient with severe atherosclerosis of the ascending aorta and one in a patient having triple vessel bypass using cephalic vein because of limited conduit material. Only one graft was closed without apparent cause and judged potentially suitable for reoperation. CECT was found to be a safe and potentially useful means of assessing early graft patency, particularly in patients sustaining untoward clinical events.
早期隐静脉冠状动脉搭桥移植血管通畅率已被发现介于82%至94%之间。计算机断层扫描技术的最新进展促使了一种安全、有效且“相对无创”的评估早期移植血管通畅情况的方法的发展。我们设计了一项使用对比增强计算机断层扫描（CECT）的前瞻性研究，假定如果证实早期血管闭塞，在心包粘连形成之前可对选定的移植血管进行再次手术。43例接受择期冠状动脉搭桥手术的随机患者组成了研究组。所有患者在术后平均6天（范围为1至17天）接受了移植血管通畅情况的CECT检查。96根移植血管中有90根通畅，早期通畅率为94%。3根移植血管因远端血流不佳或广泛的冠状动脉远端动脉粥样硬化而闭塞。另有2根移植血管闭塞，1根发生在升主动脉严重动脉粥样硬化的患者中，1根发生在因管道材料有限而使用头静脉进行三支血管搭桥的患者中。只有1根移植血管无明显原因闭塞，且被判定可能适合再次手术。CECT被发现是评估早期移植血管通畅情况的一种安全且可能有用的方法，尤其是在发生不良临床事件的患者中。
