Tedoriya T, Kawasuji M, Sakakibara N, Ueyama K, Watanabe Y
First Department of Surgery, Kanazawa University School of Medicine, Japan.
Cardiovasc Surg. 1995 Aug;3(4):381-5. doi: 10.1016/0967-2109(95)94155-p.
The haemodynamic properties of arterial grafts were studied by measuring the pressure waveform at the tip of the grafts in 28 patients who underwent coronary artery bypass surgery (CABG). The internal thoracic and gastroepiploic arteries were harvested as pedicles for CABG. Pressure wave of the ascending aorta and arterial grafts were simultaneously recorded with an electrocardiogram under stable haemodynamic conditions before cardiopulmonary bypass. Systolic, diastolic and mean pressures were measured, and mean systolic and diastolic pressures calculated for systolic and diastolic areas divided by time. The ascending aorta showed high sustained diastolic pressure that decreased gradually. Pressures in the internal thoracic and gastroepiploic artery grafts had narrow contours and decreased rapidly. Pressure waveforms in the internal thoracic and gastroepiploic artery grafts had a notch between the systolic and diastolic contours. There was no difference in systolic pressure between the ascending aorta and internal thoracic and gastroepiploic artery grafts. Diastolic pressures were 64(9), 55(7), and 51(6) mmHg in the ascending aorta and internal thoracic and gastroepiploic artery, respectively. Mean(s.d.) pressures were 75(9), 65(9) and 59(7) mmHg in the ascending aorta and internal thoracic and gastroepiploic artery grafts, respectively. Diastolic and mean pressures in the internal thoracic artery grafts were significantly lower than in the ascending aorta but significantly higher than in the gastroepiploic artery grafts. The mean(s.d.) calculated diastolic pressure in the internal thoracic artery grafts was significantly lower than in the ascending aorta but significantly higher than in the gastroepiploic artery grafts. The inferior capacity of flow through the arterial grafts may be mainly attributable to reduced diastolic pressure, which is caused by anatomical characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
通过测量28例接受冠状动脉旁路移植术（CABG）患者移植血管末端的压力波形，研究了动脉移植血管的血流动力学特性。胸廓内动脉和胃网膜动脉被采集作为CABG的带蒂血管。在体外循环前血流动力学稳定的情况下，用心电图同时记录升主动脉和动脉移植血管的压力波形。测量收缩压、舒张压和平均压，并计算收缩期和舒张期面积除以时间得到的平均收缩压和舒张压。升主动脉显示出持续的高舒张压，且逐渐降低。胸廓内动脉和胃网膜动脉移植血管的压力轮廓较窄且下降迅速。胸廓内动脉和胃网膜动脉移植血管的压力波形在收缩期和舒张期轮廓之间有一个切迹。升主动脉与胸廓内动脉和胃网膜动脉移植血管的收缩压无差异。升主动脉、胸廓内动脉和胃网膜动脉的舒张压分别为64（9）、55（7）和51（6）mmHg。升主动脉、胸廓内动脉和胃网膜动脉移植血管的平均（标准差）压力分别为75（9）、65（9）和59（7）mmHg。胸廓内动脉移植血管的舒张压和平均压显著低于升主动脉，但显著高于胃网膜动脉移植血管。胸廓内动脉移植血管计算得到的平均（标准差）舒张压显著低于升主动脉，但显著高于胃网膜动脉移植血管。动脉移植血管较低的血流能力可能主要归因于舒张压降 低，这是由解剖学特征引起的。（摘要截短至250字）
