OPCABにおけるskeletonized gastroepiploic arteryグラフトによるsequential吻合の評価

概要

論文の詳細を見る
From 2002, our standard strategy for coronary revascularization was off-pump coronary artery bypass grafting (OPCAB). The gastroepiploic artery (GEA) was used as an in situ arterial grafts for multiple vessel revascularization. This study was to review the skeletonized GEA sequential grafting in OPCAB. Thirty-eight patients (32 males, aged 44 to 80 years) underwent sequential grafting of the skeletonized GEA in OPCAB between January 2002 and December 2004. The GEA was harvested in complete skeletonized fashion using an ultrasonic scalpel. The dissected GEA was placed on the antegastric and antehepatic route and led into pericardial space. The GEAs were anastomosed to the right coronary artery brunches in 25 cases and the right and the left circumflex artery brunches in 10 cases. Overall, 74 distal anastomoses were done using in situ GEAs. There were no inhospital deaths among the study patients. The patency rate of the GEAs was 97% (72 of 74 distal anastmoses) on postoperative angiogram. Two terminal anastomoses of sequential grafts were occluded. The flow competition between the coronary artery was noted in the terminal segment in 3 cases. The acceptable early clinical and angiographic outcome suggests the GEA sequential grafting is safe and effective for multiple coronary revascularization.
東京女子医科大学の論文