Total Arterial Revascularization with Internal Mammary Artery or Radial Artery π Graft Configuration

作     者：邓勇志 孙宗全 Hugh S PATERSON 

作者机构：Department of Cardiovascular Surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China Department of Cardiothoracic Surgery Westmead Hospital Sydney University NSW 2145 Australia 

出 版 物：《Journal of Huazhong University of Science and Technology(Medical Sciences)》 (华中科技大学学报（医学英德文版）)

年 卷 期：2005年第25卷第5期

页      面：571-574页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：coronary artery bypass total arterial revascularization π graft 

摘      要：Summary： To investigate the clinical use of π graft in total arterial revascularization and its outcomes, a retrospective analysis of 23 patients out of 1000 patients undergoing total arterial coronary bypass surgery with a π graft between September 1994 and December 2004 was performed. In the selected patients for the management of triple vessel disease with middle diagonal/intermediate ramus disease such that a skip with the left internal mammary artery （LIMA） or radial artery （RA）, the main stem of π graft, to the left anterior descending coronary artery （LAD） will not work and the right internal mammary artery （RIMA） or right gastroepiploic artery （RGEA） cannot pick up the diagonal/intermediate ramus, hence the LAD and diagonal/intermediate ramus were grafted with a mini Y graft using the distal segment of LIMA, RIMA, RA or RGEA, together with the bilateral internal mammary artery （BIMA） or LIMA-RA T graft to compose π graft. Twenty-three patients （18 males, 5 females） underwent the π graft procedure. There were no deaths or episodes of myocardial infarction, stroke, and deep sternal wound infection. One patient required reopening for controlling bleeding. Until the end of 2004, during a mean follow-up of 81.0±28.4 months, no angina needing re intervention or operative therapy or coronary related death occurred. In conclusion, in patients with specific coronary artery anatomy/stenosis, the BIMA （sometimes LIMA with RA or RGEA） π graft can be successfully performed for total arterial revascularization with good midterm outcomes.