Watanabe G, Misaki T, Yamamoto K, Cremer J, Haverich A, Borst H G, Watanabe Y
Department of Surgery (1), Toyama Medical and Pharmaceutical University, Japan.
Kyobu Geka. 1994 Feb;47(2):89-93; discussion 94-7.
Between 3/91 and 3/93 twenty-nine patients (pts.) with a mean age of 55 years (30-68) underwent CABG (including 3 reoperation) using inferior epigastric artery (IEA) in addition to internal thoracic artery and saphenous vein graft. IEAs were harvested as pedicles with a mean length of 12.2 cm (7.5-17). Overall distal anastomoses were performed 3.2 per patients. And a mean of 2.3 anastomoses were completed as an arterial graft. IEA grafts were applied to left anterior descending artery in 10, diagonal branch in 15, in marginal branches in 2 and right coronary artery in 2. Mean cardiopulmonary bypass time amounted to 103 minutes and operation procedures were completed in 258 minutes (mean). Aortic cross clamp time of 48 minutes were required. One patient was died of cerebral accident 23 days postoperatively. Except for two abdominal wall infection no wound healing problems occurred. One reexploration for bleeding were necessary. Postoperative angiography revealed patent IEA grafts in 12 of 13 patients (92%). We concluded that the application of IEAs for CABG is available as a third arterial graft and with respect to intraoperative management and perioperative complications use of IEA combined with ITAs appears suited or superior to the use of the right gastroepiploic artery.
在1991年3月至1993年3月期间，29例平均年龄55岁（30 - 68岁）的患者接受了冠状动脉旁路移植术（CABG）（包括3例再次手术），除了使用胸廓内动脉和大隐静脉移植外，还使用了腹壁下动脉（IEA）。IEA作为蒂进行采集，平均长度为12.2厘米（7.5 - 17厘米）。每位患者平均进行3.2次远端吻合。平均完成2.3次动脉移植吻合。10例将IEA移植至左前降支，15例至对角支，2例至边缘支，2例至右冠状动脉。平均体外循环时间为103分钟，手术平均在258分钟内完成。需要48分钟的主动脉阻断时间。1例患者术后23天死于脑意外。除2例腹壁感染外，未出现伤口愈合问题。1例因出血需要再次探查。术后血管造影显示13例患者中有12例（92%）的IEA移植血管通畅。我们得出结论，IEA用于CABG作为第三种动脉移植是可行的，就术中管理和围手术期并发症而言，IEA与胸廓内动脉联合使用似乎比使用胃网膜右动脉更合适或更具优势。
