双侧胸廓内动脉搭桥在冠心病心肌再血管化中的应用

在心肌再血管化中采用单侧或双侧胸廓内动脉（ITA）各60例，单侧组完成200支冠状动脉吻合，平均每例3．3支，60支带蒂在ITA均与左前降支（LAD）吻合；双侧ITA组完成210支冠状动脉吻合，平均每例3．5支，其中60支带蒂左ITA与LAD吻合，60支右ITA中，54支为带蒂移植血管，6支为游离血管，12支经横窦与回旋支吻合，48支带蒂右ITA与右冠状动脉吻合。两组均无围术期死亡和胸骨感染，两级各有2例术后大出血开胸止血。单、双侧ITA组分别有35例和41例随诊6个月至4年，均无心绞痛再发。术后运动试验单侧组3例阳性，双侧组1例阳性。

Use of bilateral internal thoracic artery in coronaryartery bypass grafting

To improve the early and late benefits of coronary artery bypass grafting simultaneous bilateral internal thoracic artery (ITA) grafting is extensively used. In this study 60 patientswith bilateral ITA grafting were reviewed and compared with 60 patients with routine one ITAgrafting. In one ITA group 200 grafts were performed (3. 3 grafts per patient). The left ITA in situwas anastomosed with LAD in all of them. In two ITAS group 210 grafts were performed (3. 5grafts per patients). 60 of them the left ITA in situ was used to anastomose with LAD. 54 of the 60using right ITA grafts the right ITA in situ were used and 6 of them free right ITA were used. In12 patients the right ITA graft passed through transverse sinus to anastomose with circumflexartery. In the remaining 48 cases the right ITA grafts were all anastomosed with right coronaryartery. There were no perioperative deaths and no sternal infection in both grougs. Postoperatviecomplication including 2 reopen the chest for bleeding in each group. Late follow-up was completedin 35 of one ITA group and 41 of two ITAS group for 1/2 to 4 years. All patiens were asymptomatic. Exercise stress test were performed in these patiens, 3 of one ITA group and 1 of two ITAgroups were positive respectively.