Agrifoglio M, Di Matteo S, Parolari A, Naliato M, Antona C, Alamanni F, Biglioli P
Department of Cardiac Surgery, University of Milan, Italy.
Cardiovasc Surg. 1997 Jun;5(3):309-14. doi: 10.1016/s0967-2109(97)00014-8.
The right gastroepiploic artery has been increasingly used as a coronary bypass graft. Short- and mid-term patency rates support the supposition that the right gastroepiploic artery is a satisfactory bypass conduit. However, conclusive angiographic data on long-term patency rates are still lacking. An echo-colour Doppler method was used to detect patency of the right gastroepiploic artery grafts through an upper abdominal approach. A group of 24 patients with a right gastroepiploic artery graft to the right or posterior descending coronary artery, all of whom also had a postoperative angiographic study which showed 100% patency of the graft were used as a reference group. A second group of 89 patients was also investigated only with echo-colour Doppler during the postoperative period (mean 8.0 (range 1-48) months). A patent right gastroepiploic artery graft showed a biphasic velocity pattern. Systolic peak velocity ranged from 8 to 26 cm and diastolic peak velocity from 4 to 13 cm. The right gastroepiploic artery diameter ranged from 1.7 to 2.4 mm and flow from 10.2 to 58.8 ml. Among the second group were three patients who had, at their echo-colour Doppler examination, a possible occlusion of the right gastroepiploic artery graft; an angiographic study was conducted and the graft closure confirmed in all cases. Serial echo-colour Doppler evaluation of the right gastroepiploic artery blood flow pattern and diameter is a non-invasive and safe method to check the patency and flow capacity of the artery graft in follow-up studies.
胃网膜右动脉越来越多地被用作冠状动脉搭桥移植物。短期和中期通畅率支持胃网膜右动脉是一种令人满意的搭桥管道的推测。然而，关于长期通畅率的确切血管造影数据仍然缺乏。采用超声彩色多普勒方法通过上腹部途径检测胃网膜右动脉移植物的通畅情况。一组24例接受胃网膜右动脉移植至右冠状动脉或后降支冠状动脉的患者，所有患者术后血管造影研究均显示移植物100%通畅，作为参照组。第二组89例患者在术后期间（平均8.0（范围1 - 48）个月）仅接受超声彩色多普勒检查。通畅的胃网膜右动脉移植物显示出双相速度模式。收缩期峰值速度范围为8至26 cm，舒张期峰值速度范围为4至13 cm。胃网膜右动脉直径范围为1.7至2.4 mm，血流量范围为10.2至58.8 ml。在第二组中有3例患者在超声彩色多普勒检查时，胃网膜右动脉移植物可能闭塞；进行了血管造影研究，所有病例均证实移植物闭塞。在随访研究中，对胃网膜右动脉血流模式和直径进行系列超声彩色多普勒评估是一种检查动脉移植物通畅性和血流量的非侵入性安全方法。
