ENHANCED LEFT VENTRICULAR FUNCTION AFTER DISTANT CORONARY BYPASS

多支冠状动脉病变患者行冠状动脉旁路移植术 手术通常不能在所有受累的动脉上进行。因此，我们 评估冠状动脉搭桥术是否可以通过侧支改善 非旁路动脉对左室心肌功能的影响。 术中局部和整体左心功能改善 在所有搭桥术的患者中，术后锻炼相当 移植物是开放的，那些只有部分动脉旁路的移植物。 运动性室壁运动异常改善和局部射血分数 有10/11的患者在没有血运重建的区域增加。 血管造影术证实其中8例侧支循环血流灌注改善。 10例患者。因此，许多冠状动脉不能搭桥的患者可能 仍然受益于冠状动脉搭桥手术，如果危及 心肌由狭窄的动脉供应的侧支血管灌流。 可以接受搭桥手术。

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.