Results of Internal Mammary Artery-Coronary Artery Bypass Surgery and the Characteristics of Internal Mammary Artery Grafts : 50th Annual Scientific Session of the Japanese Circulation Society

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概要

• 論文の詳細を見る

• Coronary artery bypass grafting utilizing the internal mammary artery (IMA) was performed in 108 patients with an operative mortality (less than 1 month) of 0% and a hospital mortality of 1.9%. The IMA was used most often in the left anterior descending artery system in combination with saphenous vein grafts (SVG) to the right and left circumflex artery systems. Although the IMA flow was smaller than the SVG flow when measured intraoperatively by an electromagnetic flow meter, postoperative clinical, electrocardiographic, isotopic, angiographic and coronary sinus flow-metric studies all demonstrated that the IMA can respond well to myocardial blood flow demand both at rest and during exercise, resulting in excellent clinical improvements with no detectable signs of flow deficiency. In addition, no signs of ischemia were detected in any of the 15 patients with stenosis in the left main trunk treated with an IMA graft. The IMA graft appears to have a great adaptive capacity to meet increased myocardial demand. Postoperative angiography performed at an average of 3 months after surgery in 60 unselected patients demonstrated an IMA patency rate of 98% in comparison with 88% patency in SVGs to the left anterior descending artery (p<0.05). Not only the patency rate, but also the graft wall characteristics were much better in IMA grafts than in SVGs. Some SVGs showed marked wall irregularity as early as 3 months after surgery. Postoperative changes in the IMA caliber (enlargement when the run-off is great) and the lower rate of progression of stenosis in the native recipient coronary artery receiving an IMA graft have led us to conclude that the IMA graft is a "living conduit" with great adaptive capacity, acting like a very large collateral vessel created by surgery: it responds well to coronary blood flow demand in a cooperative manner with native coronary artery flow and also shows good potential for long-term patency.

• 社団法人日本循環器学会の論文
• 1987-09-20

著者

• KITAMURA Soichiro

  Department of Cardiovascular Surgery, National Cardiovascular Center

• INOUE Tsuyoshi

  Department of Materials Chemistry, Graduate School of Engineering, Osaka University

• Suyama Kazuhiro

  国立循環器病センター 心臓血管内科

• Shirao Kuniaki

  National Cardiovascular Center

• Kitamura Soichiro

  国立循環器病センター 心臓血管外科

• Kitamura Soichiro

  循環器セ

• KAWACHI Kanji

  Department of Cardiovascular Surgery, Ehime University Hospital

• Kitamura Soichiro

  Department Of Cardiovascular Surgery National Cardiovascular Center

• Takano Shinji

  愛媛県立新居浜病院 心臓血管外科

• Kawachi Kanji

  Department Of Surgery Ii Ehime University School Of Medicine

• Kawachi Kanji

  Department Of Cardiovascular Surgery Ehime University Hospital

• Taniguchi Shigeki

  Department of Surgery III, Nara Medical University

• Seki Toshio

  Department Of Nuclear Engineering Kyoto University

• Seki Toshio

  Department Of Surgery Iii Nara Medical College

• Seki Toshio

  Department Of Cardiovascular Surgery Nara Prefectural Mimuro Hospital

• KOBAYASHI Hironori

  Department of Pediatrics, Shimane University Faculty of Medicine

• Kitamura S

  Department Of Surgery Osaka University Hospital And Nara Medical College Hospital

• MORITA RYUICHI

  Department of Surgery III, Nara Medical College

• NISHI TSUTOMU

  Department of Surgery III, Nara Medical College

• OYAMA CHOKEN

  Department of Surgery III, Nara Medical College

• NISHII TSUTOMU

  Department of Surgery III, Nara Medical College

• Kitamura Soichiro

  3rd Department Of Surgery Nara Medical College

• Kitamura Soichiro

  Department Of Cardiology National Cardiovascular Center

• Oyama Choken

  Department Of Surgery Iii Nara Medical College

• Oyama Choken

  1st Department Of Surgery Osaka University Medical School

• Nishii Tsutomu

  Department Of Surgery Iii Nara Medical College

• Morita Rhuichi

  Department Of Surgery Iii Nara Medical College

• Kitamura Soichiro

  Department Of Surgery Iii Nara Medical College

• Oyama Choken

  Department Of Surgery Iii Nara Medical Collge

• Kitamura Soichiro

  Department Of Physiology Ii Nara Medical University

• Takano Shinji

  Department Of Thoracic And Cardiovascular Surgery Nara Medical University

• Taniguchi Shigeki

  Department Of Pathobiochemistry Faculty Of Pharmacy Meijo University

• Ohyama Choken

  1st Dept. Of Surg. Osaka Univ. School Of Med.

• Ohyama Choken

  1st Dept. Of Surgery Osaka Univ. School Of Med

• Kawachi Kanji

  Department Of Organ Regenerative Surgery Ehime University Graduate School Of Medicine

• Kobayashi Hironori

  Department Of Pediatrics Shimane University School Of Medicine

• Kobayashi Hironori

  Department Of Surgery Iii Nara Medical College

• Inoue Tsuyoshi

  Department Of Electrical Engineering Nagaoka University Of Technology

• Inoue Tsuyoshi

  Department Of Surgery Iii Nara Medical College

• Inoue Tsuyoshi

  Department Of Appied Chemistry Faculty Of Engineering Osaka University

• Kobayashi Hironori

  Department Of Earth Sciences Faculty Of Science Toyama University

• Ohoyama Choken

  1st Dept. Of Surg. Osaka Univ. School Of Med.

• Kitamura Soichiro

  1st Dept Of Surgery Osaka University

• Kawamura Shinji

  1st Department Of Surgery Medical School Osaka Univ.

• Kawamura Shinji

  1st Dept. Of Med. Osaka Univ. Med. School

• Kobayashi Hironori

  Department of Chemistry, Osaka Kyoiku University

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