Possati G, Gaudino M, Alessandrini F, Luciani N, Glieca F, Trani C, Cellini C, Canosa C, Di Sciascio G
Departments of Cardiac Surgery and Cardiology, Catholic University, and the Department of Cardiology, Campus Biomedico University, Rome, Italy.
J Thorac Cardiovasc Surg. 1998 Dec;116(6):1015-21. doi: 10.1016/S0022-5223(98)70054-6.
To evaluate the midterm angiographic results of the use of radial artery grafts for myocardial revascularization.
The first 68 consecutive surviving patients who received a radial artery graft proximally anastomosed to the aorta at our institution were studied again at 5 years (mean 59 +/- 6.5 months) of follow-up; 48 of these patients had previously undergone an early angiographic examination. The response of the radial artery to the endovascular infusion of serotonin was evaluated 1 and 5 years after the operation, and the midterm status of the radial artery graft was correlated with the degree of preoperative stenosis of the target vessel and with calcium-channel blocker therapy.
The patency and perfect patency rates of the radial artery grafts 5 years after the operation were 91.9% and 87.0%, respectively. All radial artery grafts that were patent early after the operation remained patent at midterm follow-up, and early parietal irregularities in 7 patients were seen to have disappeared after 5 years. The early propensity toward graft spasm after serotonin challenge was markedly decreased at midterm follow-up. The continued use of calcium-channel antagonists after the first postoperative year did not influence the radial artery graft status, whereas the preoperative severity of the target-vessel stenosis markedly influenced the angiographic results.
The midterm angiographic results of radial artery grafts used for myocardial revascularization are excellent. The correct surgical indication is essential. Continued therapy with calcium-channel antagonists after the first year does not influence the midterm angiographic results.
评估使用桡动脉移植物进行心肌血运重建的中期血管造影结果。
对在我院接受近端与主动脉吻合的桡动脉移植物的首批68例连续存活患者进行了为期5年（平均59±6.5个月）的随访研究；其中48例患者此前已接受早期血管造影检查。在术后1年和5年评估桡动脉对血管内输注5-羟色胺的反应，并将桡动脉移植物的中期状态与靶血管术前狭窄程度及钙通道阻滞剂治疗情况进行关联分析。
术后5年桡动脉移植物的通畅率和完美通畅率分别为91.9%和87.0%。所有术后早期通畅的桡动脉移植物在中期随访时仍保持通畅，7例患者早期出现的血管壁不规则在5年后消失。5-羟色胺激发试验后早期移植物痉挛倾向在中期随访时明显降低。术后第1年之后继续使用钙通道拮抗剂对桡动脉移植物状态无影响，而靶血管术前狭窄的严重程度对血管造影结果有显著影响。
用于心肌血运重建的桡动脉移植物的中期血管造影结果极佳。正确的手术指征至关重要。术后第1年之后继续使用钙通道拮抗剂不影响中期血管造影结果。
