左侧肋间后动脉用于冠状动脉搭桥术的应用解剖

Applied anatomy of coronary artery bypass grafting by left posterior intercostal artery

目的 :为左侧肋间后动脉冠状动脉搭桥术提供解剖学基础。方法 :在 3 0具成人尸体标本上 ,对左侧肋间后动脉及心脏冠状动脉的后降支和左缘支进行了观测。结果 :左侧第 8、9、10肋间后动脉到后降支 (房室交点下方 1cm处 )平均外径分别为 2 .5、2 .6、2 .8mm ,与冠状动脉后降支此点处外径 ( 2 .5mm)较为接近 ;到左缘支起点处的平均外径为 2 .7、2 .8、2 .6mm ,与左缘支此点处外径 ( 2 .1mm)较为接近 ;到后降支中点处平均外径为 2 .1、2 .3、2 .6mm ,与后降支中点的外径 ( 1.9mm)较为接近。第 8、9、10肋间后动脉自起点的剥离有效长度可达 12cm ,其有效长度和外径足以适用于心脏后壁的血管搭桥。结论 :本文测量结果显示选择左侧肋间后动脉作为桥接血管 ,可能是解决心脏后壁冠状动脉旁路术的较理想血管。

Objective: To provide anatomic basis for coronary artery bypass grafting (CABA) by left posterior intercostal artery (LPIA). Methods: We dissected 30 adult cadavers to measure and observe the LPIA, posterior descending branch and left marginal branch of coronary artery. Results: The average diameters of the 8th, 9th and 10th LPIA to the point of origin of posterior descending branch and left marginal branch were 2.5 mm, 2.6 mm, 2.8 mm and 2.7 mm, 2.8 mm, 2.6 mm respectively, which was very similar to the diameter of posterior descending branch and left marginal branch at that point (2.5 mm and 2.1 mm separtely). Those average diameters to the middle point of posterior descending branch were 2.1 mm, 2.3 mm and 2.6 mm, which similar to the same site of posterior descending branch (1.9 mm). The available length of those arteries could reach 12 cm. Conclusion: The LPIA (8th, 9th and 10th) could be a suitable graft for CABA.