乳内动脉-冠状动脉旁路移植术53例

作者对１９９４年１月～１９９６年１２月本院所作的５３例乳内动脉（ＩＭＡ）－冠状动脉旁路移植术进行了总结。全部患者均为经内科治疗效果不满意者。其中４４例发生过一次以上的心肌梗塞；１６例合并室壁瘤形成。除１例为非体外循环行单纯左ＩＭＡ与左前降支吻合外，其余均行左ＩＭＡ吻合前降支及大隐静脉序惯“蛇形”桥。全组平均做冠脉吻合口４．２８支。同期左室室壁瘤切除４例。手术死亡４例。３５例随访６个月～１年半，其中３０例症状消失，５例症状减轻，活动量增加。随访结果提示，ＩＭＡ冠脉旁路移植术可取得满意疗效。作者还对ＩＭＡ冠脉旁路移植术的技术要点、适应证等进行了讨论。

Coronary artery bypass graft with internal mammary artery in 53 cases

Coronary bypass graft(CABG) with internal mammary artery was used (IMA) in 53 cases.they were treated medically but not effective. More than one time myocardial infarctions occurred 44 cases, and 16 of them had complicated ventricular aneurysm.All of them had moderate hypothermia cardiopulmonary bypass except one,who was only subiected to anastomosis of left IMA to left anterior descending branch without cardiopulmonary bypass.The mean grafts of this group were 4.28(lift ventricular aneurysmectomy was performed simultaneoysly in 4 cases).Operative death was occurred in 4 cases.Of the 35 cases which had been followed for 6 months to 1 year,30 were free of symptoms,5 got better and had more physical exertion.It is suggested that CABG with IMA is satisfactory.