大隐静脉序贯式完全性冠状动脉血运重建远期随访

Long-term results of coronary artery complete revascularization with sequential saphenous vein grafts

目的回顾性研究早期冠状动脉搭桥接受2条序贯式大隐静脉行完全性冠状动脉血运重建患者的远期情况。方法随访11例患者平均15年存活的情况和大隐静脉桥的改变情况。结果无手术死亡,5年11例全部存活,10年10例存活,15年9例存话。3例冠状动脉造影2例4个吻合口和1例5个吻合口完全通畅,静脉桥形态良好,1例患者14年接受CTA检查,1条静脉桥因冠状动脉严重钙化而闭塞,另1条序贯式桥良好没有软斑块和钙化。结论除影响静脉桥远期诸多因素以外,序贯式静脉桥伴高质量的吻合口也是桥远期开放的重要因素之一,应用静脉桥时要确保吻合口的质量。

Objective Long-term results of the patients with coronary artery complete revascularization with two sequential saphenous vein grafts were retrospectively studied. Methods Follow-up consecutive 11 patients survival condition, who received CABG from Nov 1989 and Dec 1992 and saphenous vein graft patency saturation. Results There was no mortality 5,10 and 15 year survival rate were 11/11, 10/11 and 9/11 patients respectively. 3 patients had coronary angiography examination made, 4 distal anastomoses in 2 patients and 5 distal anastomoses in 1 patients were patency and 1 had CTA, in which 1. graft was complete occluded due to severe calcification in LAD, the other sequential graft with two distal anastomoses were patency and no soft plaque and calcification were found in the vein graft. All the saphenous vein graft had normal morphology without severe narrowing and extension at morphology of coronary angiography. Conclusion Expect the other factors to influence the vein graft patency rate, the sequential grafts with good quality anastomoses were one of the important factors to long term patency rate of the vein graft, so that when the saphenous vein was used as a graft, high good quality anastonosis must be assured.