Hayashi I, Hosoda Y, Sasaguri S, Satou T, Takazawa K, Yamamoto S
Department of Thoracic Surgery, Juntendo University School of Medicine, Tokyo.
Rinsho Kyobu Geka. 1994 Oct;14(5):390-3.
Since 1984, 1410 patients underwent coronary bypass grafting at Juntendo University Hospital. At the primary operation 797 patients had internal thoracic artery (ITA) graft and 613 patients received only saphenous vein graft (SVG). Reoperation was done in one pt. in ITA group and 10 pts. in SVG group. There were 2 deaths (reoperative mortality 18%). Percutaneous Transluminal Coronary Angioplasty to stenotic SVG was applied to 71 lesions in CABG patients. The primary success rate was 81.7% and restenosis rate was 38.9%. Urgent reoperation was performed on 3 pts. who had PTCA to diseased LAD or stenotic SVG to LAD. Reoperation is technically demanding and is associated with high mortality. Balloon angioplasty may provide a suitable alternative. But high restenosis rate (especially acute stenosis) remains a significant problem, particularly in the pts. with diseased LAD or stenotic vein graft to LAD. Reoperation is another option to relieve the ischemic symptoms in pts. with diseased LAD or stenotic vein graft to LAD.
自1984年以来，顺天堂大学医院有1410例患者接受了冠状动脉搭桥术。初次手术时，797例患者接受了胸廓内动脉（ITA）移植，613例患者仅接受了大隐静脉移植（SVG）。ITA组有1例患者接受了再次手术，SVG组有10例患者接受了再次手术。有2例死亡（手术死亡率18%）。对冠状动脉搭桥术患者的71处狭窄大隐静脉移植物进行了经皮腔内冠状动脉成形术。初次成功率为81.7%，再狭窄率为38.9%。对3例病变位于左前降支或左前降支狭窄大隐静脉移植物的患者进行了紧急再次手术。再次手术技术要求高，且死亡率高。球囊血管成形术可能是一种合适的替代方法。但高再狭窄率（尤其是急性狭窄）仍然是一个重大问题，特别是在病变位于左前降支或左前降支狭窄静脉移植物的患者中。再次手术是缓解病变位于左前降支或左前降支狭窄静脉移植物患者缺血症状的另一种选择。
