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[胃网膜右动脉(RGEA)移植物的临床评估——在仅使用动脉移植物的冠状动脉旁路移植术(CABG)中RGEA与右胸廓内动脉(RITA)移植物的比较]

[Clinical evaluation of right gastroepiploic artery (RGEA) graft--comparison of RGEA with right internal thoracic artery (RITA) graft in the coronary bypass grafting (CABG) operation using only arterial grafts].

作者信息

Hayashi S, Sasaki M, Kawamoto J, Kawaue Y

机构信息

Department of Cardiovascular Surgery, Chugoku Rosai Hospital, Kure, Japan.

出版信息

Jpn J Thorac Cardiovasc Surg. 1998 Jun;46(6):538-43. doi: 10.1007/BF03250596.

Abstract

From January, 1990 through May, 1997, 100 CABG operations were conducted using only double arterial grafts. RITA/left internal thoracic artery (LITA) (n = 38) and RGEA/LITA (n = 62) groups were compared. The incidence of left main trunk lesion was higher in the RITA/LITA group (29%: 13%), and old myocardial infarction was greater in RGEA/LITA group (77%: 55%). Mean age in the RGEA/LITA group showed high tendency (66.8 +/- 8.5: 63.9 +/- 9.2). Both groups were essentially the same with respect to sex, poor left ventricular function, pre-operative aortic baloon pumping (IABP), diabetes mellitus, hypertension, cerevral vascular disease, hyperlipidemia, smoking, pre-operative ejection fraction (EF). Focal skin infection (32%: 6%) and total operative field infection (focal skin infection + mediastinitis) (39%: 8%) were higher in the RITA/LITA group. Operation time (443 +/- 81: 405 +/- 114) and pleural effusion (29%: 15%) showed high tendency in the RGEA/LITA group. Extracorporeal circulation time, aorta cross-clamping time, reoperation due to bleeding, reoperation due to mediastinitis, post-operative IABP, and post-operative EF were the same for the two groups. The difference of survival rate and cardiac event-free rate between two groups were not recognized. The RGEA/LITA group showed lower complication and similar survival rates than the RITA/LITA group. Based on the present results. RGEA may be considered more usefull than RITA.

摘要

从1990年1月至1997年5月,仅使用双动脉移植物进行了100例冠状动脉旁路移植术(CABG)。比较了右乳内动脉(RITA)/左乳内动脉(LITA)组(n = 38)和桡动脉(RGEA)/LITA组(n = 62)。RITA/LITA组左主干病变的发生率更高(29%: 13%),RGEA/LITA组陈旧性心肌梗死更多(77%: 55%)。RGEA/LITA组的平均年龄呈较高趋势(66.8±8.5: 63.9±9.2)。两组在性别、左心室功能差、术前主动脉球囊泵血(IABP)、糖尿病、高血压、脑血管疾病、高脂血症、吸烟、术前射血分数(EF)方面基本相同。RITA/LITA组的局部皮肤感染(32%: 6%)和总手术野感染(局部皮肤感染+纵隔炎)(39%: 8%)更高。手术时间(443±81: 405±114)和胸腔积液(29%: 15%)在RGEA/LITA组呈较高趋势。两组的体外循环时间、主动脉阻断时间、因出血再次手术、因纵隔炎再次手术、术后IABP和术后EF相同。未发现两组之间生存率和无心脏事件发生率的差异。RGEA/LITA组比RITA/LITA组并发症更低且生存率相似。基于目前的结果,RGEA可能比RITA更有用。

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