Yamaguchi A, Kitamura N, Miki T, Kawashima M, Tamura H
Department of Cardiovascular Surgery, Osaka National Hospital.
Kokyu To Junkan. 1993 Jun;41(6):577-80.
We analyzed the graft patency rates of the individual saphenous vein graft (SVG) group and those of the sequential SVG group. In the individual SVG group, 184 SVGs were anastomosed to 184 coronary arteries. Twenty-six SVGs were used sequentially to 52 coronary arteries in the sequential group. The patency rates of all the SVGs in both groups showed no significant differences. The patency of left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and diagonal branch (Dx) was 96%, 67%, 90% and 63% respectively in the individual SVG group. In the sequential SVG group, the patency rates of LCX (95%) were much higher than those (67%) of the individual SVG group (p < 0.05). The patency rates of side-to-side anastomoses (SSAs) were 92% and those of the distal end-to-side anastomoses (ESAs) were 96% in the sequential SVG group. There were no significant differences between SSAs and ESAs. While, the patency rates of SSAs-Dx, ESAs-Dx, SSAs-LCX and ESAs-LCX were 89%, 100%, 100%, and 93% respectively in the sequential SVG group. There were no significant differences between two groups. These results showed that the sequential grafting is useful and effective for LCX coronary arteries in coronary artery bypass surgery. In conclusion, it seems that in LCX coronary arteries, the patency rates obtained by the sequential SVG technique are better than those obtained by using the individual SVG technique.
我们分析了单支大隐静脉移植（SVG）组和序贯SVG组的移植血管通畅率。在单支SVG组中，184支SVG与184支冠状动脉进行了吻合。在序贯组中，26支SVG被依次用于52支冠状动脉。两组中所有SVG的通畅率均无显著差异。在单支SVG组中，左前降支（LAD）、左旋支（LCX）、右冠状动脉（RCA）和对角支（Dx）的通畅率分别为96%、67%、90%和63%。在序贯SVG组中，LCX的通畅率（95%）远高于单支SVG组（67%）（p<0.05）。序贯SVG组中侧侧吻合（SSA）的通畅率为92%，远端端侧吻合（ESA）的通畅率为96%。SSA和ESA之间无显著差异。同时，序贯SVG组中SSA-Dx、ESA-Dx、SSA-LCX和ESA-LCX的通畅率分别为89%、100%、100%和93%。两组之间无显著差异。这些结果表明，在冠状动脉旁路移植手术中，序贯移植对LCX冠状动脉是有用且有效的。总之，在LCX冠状动脉中，序贯SVG技术获得的通畅率似乎优于单支SVG技术获得的通畅率。
