ENHANCED LEFT VENTRICULAR FUNCTION AFTER DISTANT CORONARY BYPASS

在多支冠状动脉疾病患者中， 外科手术通常不能在所有涉及的动脉上进行。 因此我们 评价冠状动脉搭桥术是否可以通过侧支循环改善 非旁路动脉所服务的左心室心肌的功能。 治疗期间局部和整体左心室功能的改善 所有旁路手术患者术后的运动量相同， 移植物是通畅的，那些只有部分旁路动脉。 运动室壁运动异常改善，局部射血分数 10/11例患者在未血运重建的区域增加。 其中8例通过血管造影证实侧支灌注改善 10个病人。 因此，许多无法进行冠状动脉旁路移植术的患者可能 冠状动脉搭桥手术仍然受益，如果危及 心肌由狭窄动脉供血的侧支血管灌注 适合做搭桥手术

In patients with multivessel coronary artery disease, coronary bypass surgery often cannot be performed on all involved arteries. We therefore evaluated whether coronary artery bypass can, through collaterals, improve function in left ventricular myocardium served by nonbypassed arteries. Improvement in regional and global left ventricular function during exercise after operation was equivalent in patients in whom all bypass grafts were patent and those with only partially bypassed arteries. Exercise wall motion abnormalities improved and regional ejection fraction increased in 10/11 patients in regions that were not revascularized. Improved collateral perfusion was documented by angiography in 8 of these 10 patients. Hence, many patients with a nonbypassable coronary artery may still benefit from coronary artery bypass surgery, if the jeopardized myocardium is perfused by collateral vessels supplied by a stenosed artery amenable to bypass surgery.