前降支旁路移植策略桥血管选择及通畅率研究

Study on vascular selection and patency rate of anterior descending artery bypass bridge

冠状动脉旁路移植术是治疗冠心病的有效手段。左前降支作为冠状动脉三大分支之一,其再血管化对于抢救患者生命、改善缺血症状非常重要,尤其是内乳动脉到左前降支的吻合至今仍是冠状动脉再血管化的“金标准”。对左前降支进行旁路移植术,可选择的桥血管材料包括游离或原位左右乳内动脉,游离或原位胃网膜右动脉,游离桡动脉、大隐静脉等。但是不同桥血管到左前降支的吻合策略和通畅率仍有待深入研究,本文总结了近30年的国内外文献资料,初步探讨不同桥血管选择策略及左前降支旁路移植的通畅率。

Coronary artery bypass grafting is an effective treatment for coronary atherosclerotic heart disease.The left anterior descending artery is one of the three branches of the coronary artery whose revascularization is very important for salvaging the patient's life and improving the ischemic symptoms. Especially the anastomosis of the internal mammary artery to the left anterior descending artery is still the "gold standard"of coronary revascularization.When the left anterior descending artery is bypassed the alternative vascular materials include free or in situ left and right internal mammary artery,free or in situ right gastroepiploic artery,free radial artery and saphenous vein.However,the anastomosis strategy and patency rate of different bridge vessels to the left anterior descending artery remain to be further studied.This paper summarizes the domestic and foreign literatures for nearly 30 years and initially discusses selection strategies of different bridge vessel and patency rate bridging to left anterior descending artery.