Sato T, Isomura T, Hisatomi K, Hayashida N, Fukunaga S, Enomoto N, Komesu I, Kosuga K, Ohishi K
Second Department of Surgery, Kurume University Hospital, Japan.
Kyobu Geka. 1995 Nov;48(12):1025-9.
The usefulness of the free inferior epigastric artery (IEA) as a coronary bypass graft was studied. Among 149 patients for coronary bypass grafting (CABG) between October 1992 and December 1994, the free IEA was used in 12 patients. The mean number of distal anastomosis was 3.7 per patient. The mean distal size of the IEA was 1.3 mm in diameter and the mean length was 9.4 cm. The IEA graft was anastomosed to the obtuse marginal branch in 5, to the diagonal branch in 4, and the right ventricular branch in 3. The proximal anastomosis of the IEA was constructed to the ascending aorta in three and to the saphenous vein (SVG) or to the internal thoracic artery (ITA) in 4 or 5, respectively. Postoperative angiogram demonstrated patent graft in ten and occluded graft in two in whom the size of IEA was less than 1.0 mm in distal diameter and the IEA was anastomosed to the aorta or to the SVG. The IEA was considered to be useful alternative arterial graft when it was used as "interposed graft" of which proximal anastomosis was made to the ITA and size-matching of the graft to the coronary artery was appropriate. The long-term patency of the graft can determine the true efficacy of the IEA for CABG.
研究了游离腹壁下动脉(IEA)作为冠状动脉旁路移植血管的效用。在1992年10月至1994年12月期间接受冠状动脉旁路移植术(CABG)的149例患者中,12例使用了游离IEA。每位患者远端吻合口的平均数量为3.7个。IEA的平均远端直径为1.3毫米,平均长度为9.4厘米。IEA移植物与5支钝缘支、4支对角支和3支右心室支进行了吻合。IEA的近端吻合分别有3例构建于升主动脉,4例或5例构建于大隐静脉(SVG)或胸廓内动脉(ITA)。术后血管造影显示,10例移植物通畅,2例移植物闭塞,这2例患者的IEA远端直径小于1.0毫米,且IEA与主动脉或SVG进行了吻合。当IEA用作近端吻合于ITA的“插入移植物”且移植物与冠状动脉的尺寸匹配适当时,它被认为是一种有用的替代动脉移植物。移植物的长期通畅性可确定IEA用于CABG的真正疗效。