冠脉旁路移植手术移植血管的选择

在冠脉旁路移植手术移植血管的选择中，内乳动脉因为其移植10年后仍有高达95％的通畅率而成为首选，而且病人的生存率较高，心血管系统并发症的发生率较低。桡动脉因其1年高于95％的通畅率近年渐被广泛使用，胃网膜右动脉在移植3－4年后的通畅率大于90％，腹壁下动脉1年后的通畅率能达到80％。其他可被选择的旁路血管包括人造血管可在特殊情况下有条件地使用。在选择旁路血管时，需要综合考虑病人的年龄、临床状况和手术类型等多方面的情况。

The choice of conduits in coronary artery bypass grafting

The internal mammary artery is the first choice of coronary artery bypass grafting,with patency at about 95%,10 years after implantation.Patients who received this graft survive longer and have fewer cardiac complications than those who received only saphenous vein bypass grafts.Surgeons are currently studying other arteries that may be used as bypass conduits. The gastroepiploic artery on the greater curve of the stomach demonstrates the greatest promise, with patency greater than 90% at 3 to 4 years.The radial artery, used in the 1970s but abandoned due to poor results, may be due for a revival, since it has up to 95% patency at one year. The inferior epigastric artery (located posterior to the rectus muscle) is also under consideration,but few results ate available.However,it appears that about 80% of the conduits are patent at one year. The role of these alternative conduits has not yet been clarified in the management of coronary bypass patients. However, these preliminary observations suggest that increased use of these extremely durable bypass conduits may further improve surgical outcomes.