Mitchell I M, Essop A R, Scott P J, Martin P G, Gupta N K, Saunders N R, Nair R U, Williams G J
Departments of Cardiac Surgery and Cardiology, Killingbeck Hospital, Leeds, England.
Ann Thorac Surg. 1993 Jan;55(1):120-2. doi: 10.1016/0003-4975(93)90485-z.
Graft patency after coronary artery bypass grafting depends largely on the choice of conduit. Because an increasing number of patients have insufficient or poor-quality autologous material, there is a need for a suitable synthetic graft that is readily available and easy to handle and that has good long-term patency. Early results suggest that the bovine internal mammary artery graft may meet these criteria. We have used a total of 26 such grafts in 18 patients. Postoperative angiography has been performed in 19 grafts in 14 patients, 3 to 23 months after operation; of these grafts, 3 are currently patent (15.8%, compared with 85.7% and 75.0% patency for native internal mammary artery and saphenous vein grafts in the same patients). We report the results of clotting studies and an analysis of lipid status. These patients do not, however, appear to represent any atypical group, either in terms of coagulopathy, native coronary artery size, or the type of vessel disease. Nevertheless, our poor results contrast markedly with the early enthusiasm reported from other centers.
冠状动脉旁路移植术后的移植物通畅性在很大程度上取决于移植血管的选择。由于越来越多的患者自体材料不足或质量不佳，因此需要一种合适的合成移植物，这种移植物应易于获取、易于操作且具有良好的长期通畅性。早期结果表明，牛的胸廓内动脉移植物可能符合这些标准。我们共对18例患者使用了26个这样的移植物。14例患者中的19个移植物在术后3至23个月进行了术后血管造影；在这些移植物中，目前有3个通畅（通畅率为15.8%，而同一患者的自体胸廓内动脉和大隐静脉移植物的通畅率分别为85.7%和75.0%）。我们报告了凝血研究结果和血脂状况分析。然而，这些患者在凝血功能障碍、自身冠状动脉大小或血管疾病类型方面似乎并不代表任何非典型群体。尽管如此，我们的糟糕结果与其他中心报告的早期热情形成了鲜明对比。
