Graft selection and one-year patency rates in patients undergoing coronary artery bypass grafting.
Graft selection and one-year patency rates in patients undergoing coronary artery bypass grafting.
复制标题
接受冠状动脉旁路移植术的患者的移植物选择和一年通畅率。
DOI：
10.1016/j.athoracsur.2010.02.016
复制
发表时间：
2010
影响因子：
4.6
通讯作者：
S. Takanashi
中科院分区：
文献类型：
--
作者：
T. Fukui;M. Tabata;S. Manabe;T. Shimokawa;S. Takanashi
本研究的目的是评估用于冠状动脉旁路移植术的移植物的血管造影通畅率。METHODS我们回顾了2004年9月至2009年6月期间接受隔离冠状动脉旁路移植术的930例患者的记录。在这些患者中，95.1%接受了非体外循环冠状动脉旁路移植术。评估移植物的早期和1年血管造影通畅率，平均每例患者的血管造影通畅率为4.0 ± 1.3。手术死亡率为0.5%。2.2%的患者发生卒中，1.3%的患者发生纵隔炎。全桥血管的早期通畅率为97.4%，1年通畅率为87.5%。左胸廓内动脉、右胸廓内动脉、桡动脉、胃网膜动脉和大隐静脉移植物的一年通畅率分别为96.1%、92.0%、69.5%、81.4%和82.6%。原位和游离右内动脉移植物的1年通畅率无显著差异（p = 0.13）。桡动脉的1年通畅率明显低于游离右胸廓内动脉移植（p < 0.01）和大隐静脉移植（p < 0.01）。血管造影通畅率显示，左冠状动脉系统的双侧胸廓内动脉移植术是最可靠的策略。
BACKGROUNDThe aim of this study was to assess the angiographic patency rates of grafts used for coronary artery bypass surgery.METHODSWe reviewed the records of 930 patients who underwent isolated coronary artery bypass grafting between September 2004 and June 2009. Of these patients, 95.1% underwent off-pump coronary artery bypass grafting. Early and 1-year angiographic patency rates of grafts were assessed.RESULTSMean anastomoses per patient were 4.0 ± 1.3. Operative mortality was 0.5%. Stroke occurred in 2.2% of patients, and 1.3 % had mediastinitis. Early and 1-year patency rate of total grafts was 97.4% and 87.5%, respectively. One-year patency rate of the left internal thoracic artery, right internal thoracic artery, radial artery, gastroepiploic artery, and saphenous vein graft was 96.1%, 92.0%, 69.5%, 81.4%, and 82.6%, respectively. One-year patency rates of in situ and free right internal artery graft were not significantly different (p = 0.13). One-year patency rate of the radial artery was significantly worse than that of the free right internal thoracic artery graft (p < 0.01) and saphenous vein graft (p < 0.01).CONCLUSIONSMultiple coronary arterial revascularizations in various combinations of grafts were clinically safe and effective for isolated coronary artery bypass surgery. Bilateral internal thoracic artery grafting for the left coronary artery system was the most reliable strategy as shown by angiographic patency rates.