Tector A J, Kress D C, Downey F X, Schmahl T M
Infinity Heart Institute, Milwaukee, WI 53215, USA.
Semin Thorac Cardiovasc Surg. 1996 Jan;8(1):29-41.
Saphenous vein graft atherosclerosis continues to be the major cause of late failures of coronary artery bypass operations (CABG). The internal thoracic artery (ITA) is an ideal bypass graft because it remains free of atherosclerosis at late follow-up in most patients. Myocardial revascularization with only ITA grafts has developed in an incremental manner from single grafts of the left ITA to the left anterior descending coronary artery (LAD), to use of bilateral, free and sequential ITAs, and now recently to the use of preconstructed grafts that attach the free right ITA to the left ITA. The microanatomy and vascular reactivity of the ITA have been recently defined, and they explain why the ITA remains free of obstruction. Our techniques and results of ITA grafting developed over the past 25 years are presented.
大隐静脉移植血管动脉粥样硬化仍然是冠状动脉旁路移植术（CABG）晚期失败的主要原因。胸廓内动脉（ITA）是一种理想的旁路移植血管，因为在大多数患者的晚期随访中，它不会发生动脉粥样硬化。仅使用ITA移植血管进行心肌血运重建已逐步发展，从将左ITA单支移植到左冠状动脉前降支（LAD），到使用双侧、游离和序贯ITA，最近又发展到使用将游离右ITA连接到左ITA的预制移植血管。ITA的微观解剖结构和血管反应性最近已得到明确，这解释了为什么ITA不会发生阻塞。本文介绍了我们在过去25年中发展的ITA移植技术和结果。
