Tedoriya T, Kawasuji M, Ueyama K, Sakakibara N, Takemura H, Watanabe Y
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Ann Thorac Surg. 1993 Oct;56(4):951-6. doi: 10.1016/0003-4975(93)90362-l.
To investigate the hemodynamic characteristics of arterial grafts for coronary artery bypass grafting, we measured phasic pressure and flow patterns in three types of grafts in a canine model (n = 18). A graft from the ascending aorta (AAG), a graft from the descending aorta at the first lumbar level (DAG), analogous to a right gastroepiploic artery, and an internal thoracic artery (ITA) were anastomosed to each other. The composite graft was anastomosed to the left anterior descending coronary artery, and then the left anterior descending coronary artery was ligated. Before grafting, the AAG showed high sustained diastolic pressure, but the ITA and DAG showed rapid fall of diastolic pressures. Mean diastolic pressures were 83 +/- 2, 72 +/- 3, and 57 +/- 2 mm Hg in the AAG, ITA, and DAG (p < 0.05). Free flow in the AAG was markedly greater than in the ITA or the DAG. After grafting to the left anterior descending coronary artery, no changes were observed in diastolic pressures compared with the pregrafting values. Total blood flows were 72 +/- 6, 80 +/- 7, 57 +/- 7, and 44 +/- 6 mL/min in the left anterior descending coronary artery, AAG, ITA, and DAG, respectively. There were no differences in systolic graft flow between the three types of grafts. Diastolic blood flow in the ITA (29 +/- 4 mL/min) and DAG (18 +/- 3 mL/min) was smaller than in the AAG (48 +/- 4 mL/min) (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
为研究冠状动脉搭桥术中动脉移植物的血流动力学特征，我们在犬模型（n = 18）中测量了三种移植物的搏动性压力和血流模式。将升主动脉移植物（AAG）、第一腰椎水平降主动脉移植物（DAG，类似于右胃网膜动脉）和胸廓内动脉（ITA）相互吻合。将复合移植物吻合至左前降支冠状动脉，然后结扎左前降支冠状动脉。移植前，AAG显示持续的高舒张压，但ITA和DAG的舒张压迅速下降。AAG、ITA和DAG的平均舒张压分别为83±2、72±3和57±2 mmHg（p < 0.05）。AAG的自由血流明显大于ITA或DAG。吻合至左前降支冠状动脉后，与移植前相比，舒张压未见变化。左前降支冠状动脉、AAG、ITA和DAG的总血流量分别为72±6、80±7、57±7和44±6 mL/min。三种移植物的收缩期移植物血流无差异。ITA（29±4 mL/min）和DAG（18±3 mL/min）的舒张期血流小于AAG（48±4 mL/min）（p < 0.01）。（摘要截断于250字）
