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[使用左、右胸廓内动脉移植物进行左冠状动脉血运重建]

[The use of left and right internal thoracic artery grafts for revascularization of the left coronary artery].

作者信息

Puig L B, Papanikolau C G, Najar M P, Cividanes G V, Souto R C, Puig J C, Brandão C M, Rossini R C, Oppi E C

机构信息

Real e Benemérita Sociedade Portuguesa de Beneficiência, São Paulo.

出版信息

Arq Bras Cardiol. 1997 Jun;68(6):437-42.

PMID:9580334
Abstract

PURPOSE

To analyze the late results of patients who underwent left coronary myocardial revascularization with both internal thoracic arteries, with the right internal thoracic through the transverse sinus.

METHODS

From July/83 to September/96, 233 patients underwent myocardial revascularization, with ages ranging from 35 to 76 (average of 52.8) years. One hundred and eighty five were male and 48 female. Internal thoracic arteries (466), saphenous veins (192) and epigastric arteries (11) were employed.

RESULTS

The hospital mortality was 3% and the late mortality was 6.1%. The immediate postoperative bleeding was 0.8%, mediastinitis 1.7% and myocardial infarction 2.1%. The immediate and late coronariography showed the rates of patency, respectively: left internal thoracic artery 98% and 96%, right internal thoracic artery 96% and 92, and saphenous vein grafts 80% and 67.5%.

CONCLUSION

The main advantage in using both internal thoracic arteries in the revascularization of the left coronary branches was the better quality of life, the low rates of cardiac events and the absence of reoperation due to occlusion of the grafts.

摘要

目的

分析采用双侧胸廓内动脉,经横窦使用右胸廓内动脉进行左冠状动脉心肌血运重建患者的远期结果。

方法

1983年7月至1996年9月,233例患者接受了心肌血运重建,年龄35至76岁(平均52.8岁)。男性185例,女性48例。使用了胸廓内动脉466支、大隐静脉192支和腹壁上动脉11支。

结果

医院死亡率为3%,远期死亡率为6.1%。术后即刻出血率为0.8%,纵隔炎为1.7%,心肌梗死为2.1%。即刻和远期冠状动脉造影显示通畅率分别为:左胸廓内动脉98%和96%,右胸廓内动脉96%和92%,大隐静脉桥80%和67.5%。

结论

在左冠状动脉分支血运重建中使用双侧胸廓内动脉的主要优势在于生活质量更好、心脏事件发生率低以及无需因移植血管闭塞而再次手术。

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