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罕见的隐静脉移植物出现两个血管瘤:单支隐静脉搭桥术后发生两个巨大动脉瘤的患者

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世界核心医学期刊文摘（心脏病学分册） 2007年第8期3卷 45-45页

作者： Kurita T. Kitamura T. Yamanaka T. 郭俊 Department of Cardiology Mie University Graduate School of Medicine 2-174 Edobashi Tsu 514-8507 Japan

隐静脉移植物发生动脉瘤是冠状动脉搭桥术后的一种罕见并发症。本文报道1例在单支隐静脉搭桥术后经三维CT成像检查示两个巨大动脉瘤的患者。

关键词：隐静脉移植物巨大动脉瘤搭桥术血管瘤

左主干和隐静脉移植物痉挛:一种罕见的相关病例

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世界核心医学期刊文摘（心脏病学分册） 2005年第7期1卷 49-49页

作者： Porto I. Burzotta F. Mongiardo R. Crea F. 高登峰 Istituto di Cardiologia Dipto. di Medicina Cardiovascolare Univ. Cattolica del Sacro Cuore Largo F. Vito 8 00168 Roma Italy

We present a case of leftmain spasm which was associated with spasm of a saphenous vein graft. This case emphasizes the importance of excluding an excessive vasoconstrictory response in patients treated with percutane... 详细信息

关键词：隐静脉移植物收缩反应痉挛病介入治疗

作体-肺动脉分流术的大隐静脉移植物出现巨大动脉瘤性扩张

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中国冶金工业医学杂志 1990年第1期9卷 39-40页

作者：张晓光

作者报道2例发绀型先天性心脏病患者(均系男性),分别在2岁和4岁时行手术治疗,术中将自体大隐静脉移植物植入动脉血管中,术后情况良好。现年各为26岁和35岁,因发绀再次检查。1例经电影血管造影术确诊为动脉瘤性扩张,行Fontan术,切除静脉... 详细信息

作者报道2例发绀型先天性心脏病患者(均系男性),分别在2岁和4岁时行手术治疗,术中将自体大隐静脉移植物植入动脉血管中,术后情况良好。现年各为26岁和35岁,因发绀再次检查。1例经电影血管造影术确诊为动脉瘤性扩张,行Fontan术,切除静脉移植物动脉瘤,其直径为6cm。病理检查显示为钙化和纤维化。例2经磁共振影象诊断为动脉瘤性扩张,直径为8cm。因手术危险性大而未做切除。

关键词：动脉瘤性扩张隐静脉移植物自体大隐静脉手术危险性血管造影术影象诊断病理检查分叉部粥样硬化性阻塞性血栓

复合大隐静脉移植物用作门腔静脉分流术的进展、操作方法及经验

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国外医学.创伤与外科基本问题分册 1985年第3期 182-183页

作者：姚德成

早在40年代开展门腔静脉分流手术时,首先采用的方法是在门静脉和腔静脉(Blakemore等1945)或脾静脉和左肾静脉(Whipple 1945)之间移植一段静脉桥。这种方法至今仍被应用。本文报道美国Hackensack医院手术治疗门脉高压并发食道静脉曲张... 详细信息

早在40年代开展门腔静脉分流手术时,首先采用的方法是在门静脉和腔静脉(Blakemore等1945)或脾静脉和左肾静脉(Whipple 1945)之间移植一段静脉桥。这种方法至今仍被应用。本文报道美国Hackensack医院手术治疗门脉高压并发食道静脉曲张破裂出血9

关键词：隐静脉移植物门腔静脉分流术操作方法静脉桥分流手术左肾静脉门脉高压定位法 Whipple 腔静脉

《冶金医药情报》一九九○年第七卷第1—6期索引

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中国冶金工业医学杂志 1990年第6期9卷 51-59页

冠状动脉旁路移植桡动脉和大隐静脉的随机比较

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世界核心医学期刊文摘（心脏病学分册） 2005年第5期1卷 23-24页

作者： Desai N.D. Cohen E.A. Naylor C.D. Fremes S.E. 丁倩 Sunnybrook Women's Coll. Hlth. S. 2075 Bayview Ave. Toronto Ont. M4N 3M5 Canada Dr.

BACKGROUND: In the past decade, the radial artery has frequently been used for coronary bypass surgery despite concern regarding the possibility of graft spasm. Graft patency is a key predictor of long-term survival. We therefore sought to determine the relative patency rate of radial-artery and saphenous-vein grafts in a randomized trial in which we controlled for bias in the selection of patients and vessels. METHODS: We enrolled 561 pa tients at 13 centers. The left internal thoracic artery was used to bypass the anterior circulation. The radial-artery graft was randomly assigned to bypass the major vessel in either the inferior(right coronary)territory or the lateral(circumflex) territory, with the saphenous-vein graft used for the opposing territory(control). The primary end point was graft occlusion, determined by angiography 8 to 12 months postoperatively. RESULTS: Angiography was performed at one year in 440 patients: 8.2 percent of radial-artery grafts and 13.6 percent of saphenous-vein grafts were completely occluded(P=0.009). Diffuse narrowing of the graft(the angiographic “string sign”)was present in 7.0 percent of radial-artery grafts and only 0.9 percent of saphenous-vein grafts(P=0.001). The absence of severe native-vessel stenosis was associated with an increased risk of occlusion of the radial-artery graft and diffuse narrowing of the graft. Harvesting of the radial artery was well tolerated. CONCLUSIONS: Radialartery grafts are associated with a lower rate of graft occlusion at one year than are saphenous-vein grafts. Because the patency of radial-artery grafts depends on the severity of native-vessel stenosis, such grafts should preferentially be used for target vessels with highgrade lesions.

关键词：旁路移植移植血管左胸廓内动脉隐静脉移植物主要血管弥漫性狭窄血管闭塞血管造影前循环线样征

在阻塞冠状动脉近端和捕获栓子物质期间Proxis系统标示逆向冠状动脉血流的安全性和有效性

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世界核心医学期刊文摘（心脏病学分册） 2005年第3期1卷 14-15页

作者： Sievert H. Wahr D.W. Schuler G. 郝广华

The Feasibility And Safety Trial for its embolic protection device during transluminal intervention in coronary vessels: a European Registry (FASTER)was designed to demonstrate that (1) the Proxis embolic protection system can control anterograde flow and reverse blood flow in native coronary arteries and saphenous vein grafts; and (2) this system can capture embolic debris. Percutaneous coronary intervention on stenotic coronary lesions revolutionized treatment of coronary disease, but is associated with the risk of major adverse cardiac events. This prospective, nonrandomized, multicenter clinical feasibility and safety study enrolled 40 patients with 51 lesions at 4 centerswho underwent treatment of stenotic lesions with proximal emboli protection (Proxis system). Proxiswas successfully used 95%of the time, and embolic debris was qualitatively identified in all cases. Major adverse cardiac events occurred in 2 patients (5.0%): 1 late in-stent thrombosis resulting in death and 1 non-Q-wave infarction when a lesion was crossed before deployment of the Proxis system. Mean vessel occlusion time was 4.3±2.4 minutes. Native flow reversal was sufficient in 31 patients, with a mean aspirate volume of 11.8±6.5 ml. When the infusion catheter was used to augment reflow, mean occlusion time was 4.6 minutes. In conclusion, this trial is the first to demonstrate that retrograde blood flow can be achieved during proximal occlusion and that the Proxis system can be used safely during intervention of saphenous vein grafts and native coronary arterial lesions to capture embolic material.

关键词：冠状动脉血流 Proxis 近端隐静脉移植物安全性试验心脏不良事件腔内介入血管阻塞支架内血栓保护装置

肝素通过释放血管固定的髓过氧化物酶增加内皮NO生物利用度

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世界核心医学期刊文摘（心脏病学分册） 2006年第7期2卷 37-38页

作者： Baldus S. Rudolph V. Roiss M. 朱冰坡 University Hospital Hamburg-Eppendorf Heart Center Department of CardiologyMartinistrasse 52 20246 Ham-burg Germany Dr.

Background -Neutrophils and monocytes are centrally linked to vascular inflammatory disease, and leukocyte-derived myeloperoxidase(MPO) has emerged as an important mechanistic participant in impaired vasomotor function. MPO binds to and transcytoses endothelial cells in a glycosaminoglycan-dependent manner, and MPO binding to the vessel wall is a prerequisite for MPO-dependent oxidation of endothelium-derived nitric oxide(NO) and impairment of endothelial function in animal models. In the present study, we investigated whether heparin mobilizes MPO from vascular compartments in humans and defined whether this translates into increased vascular NO bioavailability and function. Methods and Results -Plasma MPO levels before and after heparin administration were assessed by ELISA in 109 patients undergoing coronary angiography. Whereas baseline plasma MPO levels did not differ between patients with or without angiographically detectable coronary artery disease(CAD), the increase in MPO plasma content on bolus heparin administration was higher in patients with CAD(P=0.01). Heparin treatment also improved endothelial NO bioavailability, as evidenced by flow-mediated dilation(P< 0.01) and by acetylcholine-induced changes in forearm blood flow(P< 0.01). The extent of heparin-induced MPO release was correlated with improvement in endothelial function(r=0.69, P< 0.01). Moreover, and consistent with this tenet, ex vivo heparin treatment of extracellular matrix proteins, cultured endothelial cells, and saphenous vein graft specimens from CAD patients decreased MPO burden. Conclusions -Mobilization of vessel-associated MPO may represent an important mechanism by which heparins exert antiinflammatory effects and increase vascular NO bioavailability. These data add to the growing body of evidence for a causal role of MPO in compromised vascular NO signaling in humans.

关键词：髓过氧化物酶 NO 生物利用度冠状动脉造影血流介导细胞源性葡萄糖胺聚糖隐静脉移植物血流量

应用Heartstring近端血管吻合系统的初步经验

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 60-61页

作者： Meirson D. Hauptman E. B. Medalion 孟欣 Department of Cardiothoracic Surgery The Edith Wolfson Medical Center Affil. Sackler Sch. Med. Tel A. Hol on IsraelDr.

Objective Manipulation of the aorta has been shown to be associated wit h posto perative neurologic events after surgical myocardial revascularization when the aorta is diseased. The Heartstring proximal anastomotic system (Guidant, Indiana polis, Ind) is a device designed to assist in the performance of proximal anasto moses with minimal aortic manipulation. We describe our initial experience with this product. Methods Twelve patients with a diseased aorta who underwent off-p ump myocardial revascularization and had their proximal anastomoses performed with the Heartstring device were stud ied for operative and postoperative outcomes and surgical technique. Results The mean age of the patients was 76 ±7 years. The estimated EuroSCORE perioperativ e mortality was 12%±8%. Themedian number of distal anastomoses was 3. In all patients, a saphenous vein graft was anastomosed to the aorta using the Heartstr ing device. In 5 patients, the radial artery was used as a conduit and connected proximally to a left internal thoracic artery as a Y graft, to a saphenous vein graft as a “horseshoe,”or on the hood of a saphenous vein graft. The operativ e and postoperative courses were uneventful. Three seals developed cracks and we re not used. One seal developed an unravel in its periphery but was used success fully. Conclusions The Heartstring proximal anastomotic system is a device that allows the surgeon to perform standard proximal clampless anastomoses. Elderly p atients with a diseased aorta may benefit from this device.

关键词：血管吻合 Heartstring 近端初步经验主动脉疾病隐静脉移植物非体外循环左胸廓内动脉血管重建术远端血管