Perrault L P, Carrier M, Hébert Y, Hudon G, Cartier R, Leclerc Y, Pelletier L C
Department of Surgery, Montreal Heart Institute, Quebec, Canada.
Ann Thorac Surg. 1993 Nov;56(5):1082-4. doi: 10.1016/0003-4975(95)90019-5.
The excellent long-term results with the internal mammary artery for coronary artery bypass grafting have prompted the search for other conduits with similar characteristics. From December 1989 to December 1991, the right gastroepiploic artery (RGEA) has been used as an in situ graft to the posterior descending coronary artery in 51 patients at the Montreal Heart Institute. The patients' age averaged 50 +/- 11 years. Three-vessel coronary artery disease was present in 41 patients and two-vessel disease in the remaining 10 patients. In all but 1 patient, bilateral internal mammary artery grafting was performed in addition to RGEA grafting. The number of grafts per patient averaged 3.2 +/- 0.8. There was no operative mortality. Morbidity was minimal with only myocardial infarction and a pleural effusion in 1 patient. In 1 patient, a splenectomy had to be performed because of iatrogenic tear during dissection of the RGEA. The average hospital stay was 8.2 +/- 2.6 days. Enteral nutrition was resumed on average 2 days after operation. Angiographic evaluation of RGEA grafts was performed before discharge or within the first month after surgery in 31 patients. In 28 patients (28/31, 90%) the RGEA graft was patent, two grafts were occluded, and in the remaining patient, the graft could not be visualized due to technical difficulties during angiography. A second angiographic evaluation was performed in 5 patients, 1 year after operation. Four RGEAs were patent and 1 was occluded. Clinical follow-up averaged 4 months (range 1 to 15 months).(ABSTRACT TRUNCATED AT 250 WORDS)
乳内动脉用于冠状动脉搭桥术的长期出色效果促使人们寻找具有相似特性的其他血管移植物。1989年12月至1991年12月，在蒙特利尔心脏研究所，51例患者使用了右胃网膜动脉（RGEA）作为后降支冠状动脉的原位移植物。患者平均年龄为50±11岁。41例患者存在三支冠状动脉疾病，其余10例患者为两支冠状动脉疾病。除1例患者外，所有患者在进行RGEA移植的同时还进行了双侧乳内动脉移植。每位患者的移植血管平均数量为3.2±0.8。无手术死亡病例。并发症极少，仅1例患者发生心肌梗死和胸腔积液。1例患者在解剖RGEA时因医源性撕裂不得不进行脾切除术。平均住院时间为8.2±2.6天。术后平均2天恢复肠内营养。31例患者在出院前或术后第一个月内对RGEA移植物进行了血管造影评估。28例患者（28/31，90%）的RGEA移植物通畅，2例移植物闭塞，其余1例患者因血管造影时的技术困难无法显示移植物。5例患者在术后1年进行了第二次血管造影评估。4例RGEA通畅，1例闭塞。临床随访平均4个月（范围1至15个月）。（摘要截断于250字）
