Eron Yones, Ann Cheng, Arfah Hazel Preston, Mohsin Gondal, Tom Slater, Joseph Kazibwe, Harjinder Kaur, Mark Sammut, Oliver Glover, John West, Alexander Rothman, Kenneth Morgan, James Richardson, Zulfiquar Adam, David Barmby, Javaid Iqbal, Arvindra Krishnamurthy, Dwayne Conway, Robert F Storey, Norman Briffa, Steven Hunter, Peter Braidley, Stefano Forlani, Govind Chetty, Neil Cartwright, Renata Greco, Paul D Morris, Julian P Gunn
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引用次数: 0
摘要
左乳内（胸）动脉（LIMA）在冠状动脉旁路移植术中用作动脉栓移植时，效果显著且经久耐用。有关 LIMA 失败率和原因的数据很少。本文旨在探讨次优 LIMA 移植的模式和频率。我们研究了本心胸中心 2016-2020 年进行的所有有创移植血管造影病例，并分析了 LIMA 移植的质量。在 551 例病例中，有 323 例自 2001 年以来接受了包括 LIMA 在内的孤立冠状动脉旁路移植术；其中 59 例（18%）出现了次优情况；16 例（5%）完全闭塞，26 例（8%）表现出 "字符串征"（即闭锁或索状），12 例（4%）病灶狭窄，5 例（1.5%）虽然通畅，但被置于左前降支动脉或其他血管的病变部分。最常见的失败原因是左前降支动脉靶点质量不佳和非血流限制性疾病。本文强调了这种有价值的治疗方法在当代实践中的低失败率和可能的失败模式。
Sub-optimal Internal Mammary Grafts: Incidence, Timing, and Etiology.
The left internal mammary (thoracic) artery (LIMA), when used as a pedicle graft at the time of coronary artery bypass grafting, is effective and durable. Data concerning the rate and causes of LIMA failure are scant. The aim of this paper is to explore the modes and frequency of sub-optimal LIMA grafts. We examined all cases of invasive graft angiography performed in our cardiothoracic center 2016-2020 and analyzed the quality of the LIMA graft. Of 551 cases, 323 had undergone isolated coronary artery bypass grafting including a LIMA since 2001; of those, 59 (18%) appeared sub-optimal; 16 (5%) being totally occluded, 26 (8%) exhibiting a "string sign" (i.e., atretic or cord-like), 12 (4%) being focally stenosed, and 5 (1.5%) being patent but placed on a diseased portion of the left anterior descending artery or other vessel. The commonest cause of failure were poor-quality left anterior descending artery target and non-flow-limiting disease. This paper highlights the low rate, and likely modes, of failure of this valuable treatment in contemporary practice.
期刊介绍：
A presentation of original, peer-reviewed original articles, review and case reports relative to all phases of all vascular diseases, Angiology (ANG) offers more than a typical cardiology journal. With approximately 1000 pages per year covering diagnostic methods, therapeutic approaches, and clinical and laboratory research, ANG is among the most informative publications in the field of peripheral vascular and cardiovascular diseases. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 13 days
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