Calafiore A M, Di Giammarco G, Luciani N, Maddestra N, Di Nardo E, Angelini R
Cattedra di Cardiochirurgia, Università di Chieti, Italy.
Ann Thorac Surg. 1994 Jul;58(1):185-90. doi: 10.1016/0003-4975(94)91097-9.
From October 1991 to May 1993, 130 patients were submitted to myocardial revascularization using complex preformed arterial conduits. The age ranged from 29 to 75 years (mean age, 60.1 years); 121 patients were male. One hundred twenty-six patients had double- or triple-vessel disease. The mean ejection fraction was 0.53 (range, 0.22 to 0.79); only 6 patients had an ejection fraction less than 0.35. In 6 cases the procedure was a reoperation. We used 360 arterial conduits, 163 of which as free grafts (3 left internal mammary arteries, 16 right internal mammary arteries, 86 inferior epigastric arteries, 57 radial arteries, and 1 right gastroepiploic artery). One hundred fifty-four free grafts were anastomosed to one or both internal mammary arteries and one to a radial artery. We constructed 136 complex arterial conduits (branched, lengthened, or both). In 6 cases a double arterial system had to be used in a single patient. There was no operative mortality, and no inotropic or mechanical supports were used. The overall mortality rate was 1.5%. Early angiographic controls (between the 7th and 15th postoperative days) demonstrated 100% patency; late angiographic controls (at a mean interval of 9.5 months after operation) documented a mean patency rate ranging from 94.1% of the radial arteries to 100% of the left internal mammary arteries and right gastroepiploic arteries. At a mean follow-up of 7.2 months (range, 1 to 15 months) all patients are alive without recurrence of symptoms.
1991年10月至1993年5月，130例患者接受了使用复杂预制动脉管道的心肌血运重建术。年龄范围为29至75岁（平均年龄60.1岁）；121例为男性。126例患者患有双支或三支血管病变。平均射血分数为0.53（范围为0.22至0.79）；只有6例患者的射血分数低于0.35。6例手术为再次手术。我们使用了360根动脉管道，其中163根作为游离移植物（3根左乳内动脉、16根右乳内动脉、86根腹壁下动脉、57根桡动脉和1根右胃网膜动脉）。154根游离移植物与一根或两根乳内动脉吻合，1根与桡动脉吻合。我们构建了136根复杂动脉管道（分支、延长或两者皆有）。6例患者不得不使用双动脉系统。无手术死亡，未使用任何正性肌力或机械支持。总死亡率为1.5%。早期血管造影检查（术后第7天至第15天之间）显示通畅率为100%；晚期血管造影检查（术后平均间隔9.5个月）记录的平均通畅率范围为：桡动脉94.1%，左乳内动脉和右胃网膜动脉100%。平均随访7.2个月（范围为1至15个月），所有患者均存活，无症状复发。
