Gallo I, Alvarez L, Goiti J, Larrañaga G, Marrero A, Ruiz B, Sáenz A, Larman M, Ubago J L
Servicio de Cirugía Cardiovascular, Policlínica Guipúzcoa, San Sebastián.
Rev Esp Cardiol. 1998;51 Suppl 3:51-7.
Coronary artery revascularization surgery is well established procedure throughout the world. The benefits are based on the blood perfusion through the implanted grafts distal to the coronary occlusions and continue as long as the grafts remains patent. The immediate success of this procedure is related to the surgical technique and the anatomical characteristics of the grafted coronary arteries. However, the long term results are mainly dependent on the type of grafts used. The modern era of myocardial revascularization started in the sixties with the use of saphenous vein grafts by Johnson and Favaloro. Alternative vascular conduits to the saphenous vein have been tried, and the internal mammary artery has become the first choice. In recent years, various publications have demonstrated the supremacy of the internal mammary artery over the saphenous vein when used as a single, bilateral, sequential of free graft. In order to obtain full myocardial revascularization, the use of alternatives to the internal mammary artery is required. The gastroepiploic artery, the inferior epigastric artery and the radial artery have been used as alternatives to the saphenous vein with the hope of obtaining long term results similar to the internal mammary artery.
冠状动脉血运重建手术在全球都是一种成熟的手术。其益处基于通过植入的移植物在冠状动脉闭塞远端实现的血液灌注，并且只要移植物保持通畅就会持续存在。该手术的即刻成功与手术技术以及移植冠状动脉的解剖特征有关。然而，长期结果主要取决于所使用的移植物类型。心肌血运重建的现代时代始于20世纪60年代，当时约翰逊和法瓦洛罗使用大隐静脉移植物。人们尝试了大隐静脉的替代血管管道，而胸廓内动脉已成为首选。近年来，各种出版物表明，当作为单一、双侧、序贯或游离移植物使用时，胸廓内动脉优于大隐静脉。为了实现完全的心肌血运重建，需要使用胸廓内动脉的替代物。胃网膜动脉、腹壁下动脉和桡动脉已被用作大隐静脉的替代物，以期获得与胸廓内动脉相似的长期效果。
