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首页> 外文期刊>The Thoracic and cardiovascular surgeon >Postoperative evaluation of radial artery grafts for coronary artery bypass grafting by transit-time Doppler flow measurements.
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Postoperative evaluation of radial artery grafts for coronary artery bypass grafting by transit-time Doppler flow measurements.

机译：通过渡越时间多普勒血流测量对radial动脉移植物进行冠状动脉旁路移植术的术后评估。

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Due to the histological configuration of the vessel wall, the radial artery is prone to spasm as a result of handling or harvesting. Therefore, certain degrees of arterial wall spasm are unpreventable, even with appropriate pharmacologic treatment, while using the radial artery as a bypass graft in CABG. Consequently, the radial artery is only reluctantly used compared to saphenous vein grafts in CABG. In our clinical experience, the radial artery, if harvested carefully, has proved to be an excellent bypass graft. This investigation was undertaken to study the differences in blood flow measured directly after extracorporeal circulation in radial artery grafts and venous grafts. Both grafts were compared to the left internal mammarian artery anastomosed to the LAD. METHODS: Between January 1998 and December 1999, 198 patients who were undergoing coronary artery revascularization with two grafts were retrospectively investigated. In all patients, the left internal mammarian artery (LIMA) was anastomosed to the left anterior descending branch (LAD). For the second graft, either the saphenous vein or the radial artery was used. Proximal anstomoses were performed as end-to-side into the ascending aorta. Patients were divided into four groups: Group 1: n = 79 IMA-LAD, vein to the circumflex artery; Group 2: n = 56 IMA-LAD, vein to the right coronary artery; Group 3: n = 34; IMA-LAD, radial artery to the circumflex artery; Group 4: n = 29 IMA-LAD, radial artery to the right coronary artery. Graft-flow measurements were performed using the transit-time method after extracorporeal circulation was terminated. The mean systolic, diastolic, and mean blood flow were measured, and the pulsatility index was calculated. Statistical analysis was performed using the of t-test analysis between the variables mean blood flow and pulsatility index. A p-value of < 0.05 was defined as statistically significant. RESULTS: There were no statistically significant differences in mean blood flow or pulsatility index between radial artery and saphenous vein grafts to the right coronary artery and the circumflex artery, respectively. Also, there were no differences regarding vein grafts to the right coronary artery and to the circumflex artery, or regarding radial artery grafts to the two coronaries, respectively. In group 4, significantly lower blood flow to the LAD was found compared to group 1, and a significantly higher pulsatility index compared to groups 2 and 3. CONCLUSIONS: Radial artery grafts compared to saphenous vein grafts do not show significant differences early after operation in mean blood flow or pulsatility index. Further studies are needed to evaluate long-term performance of radial arteries as coronary bypass grafts and to compare the radial artery to the right mammarian artery and the standard saphenous vein graft.
机译：由于血管壁的组织学构造，radial骨动脉由于处理或收获而易于痉挛。因此，在CABG中使用the动脉作为旁路移植物时，即使采用适当的药物治疗，也无法防止一定程度的动脉壁痉挛。因此，与CABG中的大隐静脉移植相比，the动脉仅勉强使用。在我们的临床经验中，如果仔细收集，动脉，则证明是一种出色的旁路移植物。进行这项研究是为了研究radial动脉移植和静脉移植体外循环后直接测量的血流差异。将这两个移植物与与LAD吻合的左乳内动脉进行比较。方法：回顾性研究1998年1月至1999年12月间198例行两次移植的冠状动脉血运重建术的患者。在所有患者中，左乳内动脉（LIMA）吻合至左前降支（LAD）。对于第二个移植物，使用大隐静脉或the动脉。近端吻合端对端进入升主动脉。患者分为四组：第一组：n = 79 IMA-LAD，静脉穿支于回旋动脉;第2组：n = 56 IMA-LAD，静脉至右冠状动脉;第3组：n = 34; IMA-LAD，radial动脉到回旋动脉;第4组：n = 29 IMA-LAD，radial动脉位于右冠状动脉。体外循环终止后，使用渡越时间方法进行移植物流量测量。测量平均收缩压，舒张压和平均血流量，并计算搏动指数。使用t检验分析的变量平均血流量和搏动指数之间进行统计分析。 p值<0.05被定义为具有统计学意义。结果：radial动脉和大隐静脉移植到右冠状动脉和回旋支之间的平均血流量或搏动指数无统计学意义。同样，右冠状动脉和回旋支动脉的静脉移植物，或两个冠状动脉的radial动脉移植物也没有差异。与第1组相比，第4组的LAD血流明显减少，而与第2组和第3组相比，LAD的脉动指数显着较高。平均血流量或搏动指数。需要进一步的研究来评估radial动脉作为冠状动脉旁路移植术的长期性能，并比较the动脉与右侧乳腺动脉和标准隐静脉移植物。

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