左乳内动脉转流术后与自体左前降支竞争性供血的超声研究

Ultrasonic assessment of competitive blood flow after coronary artery bypass grafting

目的:探讨左乳内动脉转流术后与自体左前降支竞争性供血的直接征象,血流动力学特点,出现的原因及临床意义。方法:行左乳内动脉左前降支原位转流术患者75例,于术后1w左右应用冠状动脉血流显像技术观察乳内动脉桥血管起始段,桥血管远段、吻合口、远端及近端左前降支情况。结果:左乳内动脉转流术后与自体左前降支竞争性供血患者共7例。冠状动脉血流显像表现为乳内动脉桥血管与自体左前降支均前向血流,或主要为前向血流,乳内动脉桥血管起始段表现为收缩期优势型频谱。结论:冠状动脉血流显像技术可揭示左乳内动脉转流术后与自体左前降支竞争性供血的直接征象,发现其产生的原因,可为临床选择冠状动脉搭桥术适应证提供依据。

Objective：To reveal the direct sign of competitive blood flow between the Left Internal Mammary Artery（LIMA） graft and native Left Anterior Descending artery（LAD）.To summarize the flow dynamics characteristics.To find the reason of competitive blood flow and clinical significance.Methods：75 patient who had undergone coronary artery bypass grafting（CABG） were examined by color Doppler of coronary flow imaging（CDCFI） and peripheral blood vessel ultrasound almost 1 week postoperatively.The proximal and distal of the LIMA graft,anastomosis,and proximal and distal LAD were examined.Results：7 patients have competitive blood flow after CABG.Both LAD and LIMA graft showed mainly antegrade flow by CDCFI.The proximal portion of the LIMA showed a dominant systolic flow pattern by Ultrasound.Conclusion：CDCFI could reveal the direct sign of competitive blood flow between LIMA graft and native LAD.It could provide the evi-dence of indication of CABG if Summed up the reason of competitive blood flow.