胸廓内动脉冠状动脉搭桥术有关的解剖学

为冠状动脉旁路术,在40具成年尸体上对胸廓内动脉及冠状动脉进行观测。在第四肋间隙,胸廓内动脉外径平均2.3mm,与冠状动脉对角支(2.3mm)、边缘支(2.1mm)、左室后支(2.0mm)、后降支(2.(?)mm)等较为接近。胸廓内动脉自起点至第五肋上缘平均长度为18.6cm,用作游离移植足以桥接升主动脉与任何冠状动脉。用起点原位的胸廓内动脉其有效长度适用于心前、侧壁的冠状动脉搭桥,但不适于与膈面一些血管如右冠状动脉远侧部或后降支搭桥。阐述和讨论了胸廓内动脉与冠状动脉搭桥的各种术式及其解剖基础。

Anatomic aspects of the internal thoracic-coronary arterial bypass

The internal thoracic artery has beenused for coronary arterial bypass inthe clinic.In this study,the authorfound that in the fourth intercostalspace the diameter of the internal th-oracic artery averaged 2.3mm,appr-oximating to that of the diagonal br-anch (2.3mm),the marginal branch(2.1mm),the posterior left ventriclebranch (2.0mm) and the posteriordescending branch (2.5mm) of the co-ronary artery,and the length of theartery was 18.6cm from its commenc-ement to the superior border of thefifth rib.Therefore,the internal th-oracic artery is anatomically conside-red to be a suitable conduit for cor-onary revascularization of the ante-rior and lateral walls of the heart,but unsuitable for that of the diaph-ragmatic aspect such as the distal pa-rt of the right coronary artery or itsposterior descending branch.