Clinical Analysis of Left Ventrical Total Artery Revascularization with "T"-type Anasto-mosis of Left Internal Mammary Artery and Radial Artery on Pump_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIJin-dong , WUYan-hong , DONGMing-feng , WANGJian-tang , CAIShou-dong , TANGPei-zhe , LIUTao , LIZhen-kun , XIAFeng , MASheng-jun

Department of Cardiac Surgery of Liaocheng People Hospital, Liaocheng 252000 Shandong, P. R. China;

Corresponding?author：

LIJin-dong, Email: jindongli_2008@126.com

Keywords：

Coronary artery bypass grafting; Radial atrtery; Total artery revascularization; On pump

DOI：

10.7507/1007-4848.20160254

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To asses the clinical result of left ventrical total artery revascularization with "T"-type anastomosis of left internal mammary artery (LIMA) and radial artery on pump. Methods We retrospectively analyzed the clinical data of 40 patients who underwent left ventrical total artery revascularization with "T"-type anasmtomosis of LIMA and radial artery on pump in our hospital between December 2013 and December 2015 year. There were 27 males and 13 females at age of 46-70 (55.0±10.2) years. The radial artery anastomosis was made sequentially to the left obtuse artery, intermediate artery, diagonal artery and left anterior descending artery. LIMA anastomosis was made to the radial artery closed to the left anterior descending artery. Saphenous vein (SV) anastomosis was made to right coronary artery. LIMA blood flow was measured with coronary artery Butterfly Flowmeter when LIMA was in suit and after operation. cTnI was measured at different time points. Complications after operation were studied. Results The blood flow of LIMA after operation was significantly different from that in suit (P < 0.05). The plasm cTnI postoperation was higher than that preoperation, but the difference was not significant. All the patients were survival. Atrial fibrillation occurred in 2 patients and low cardiac output occurred in 1 patient after operation, but they recovered quickly after proper treatment. There was no myocardial infraction or hand ischemia during postoperation. There was no recurrence of mycardial infarction within 6 months to 1 year follow-up. Graft patency was assessed using 128-slice CT coronary angiography in 25 patients. Cumulative graft patency rates were 96.0% in LIMA and 90.4% in SV grafts. Conclusion Left ventrical total artery revascularization with "T"-type anasmtomosis of LIMA and radial artery on pump is safe and effective.

Citation： LIJin-dong, WUYan-hong, DONGMing-feng, WANGJian-tang, CAIShou-dong, TANGPei-zhe, LIUTao, LIZhen-kun, XIAFeng, MASheng-jun. Clinical Analysis of Left Ventrical Total Artery Revascularization with "T"-type Anasto-mosis of Left Internal Mammary Artery and Radial Artery on Pump. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(11): 1082-1085. doi: 10.7507/1007-4848.20160254 Copy

1.	Toshihiro F, Minoru T, Masataka T, et al. Extensive reconstruction of the left anterior descending coronary artery with an internal thoracic artery graft. Ann Thorac Surg, 2011, 91(2): 445-451．.
2.	Tranbaugh RF, Dimitrova KR, Friedmann P, et al. Coronary artery bypass grafting using the radial artery: clinical outcome patency and need for reintervention. Circulation, 2012, 126(11 Suppl 1): S170-S175.
3.	Deb S, Cohen EA, Singh SK, et al. Radial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: result from RAPS (Radial artery patency study). Am Coll Cardiol, 2012, 60(1): 28-35.
4.	董明亮, 李清寶, 李德才, 等.非體外循環下左乳內動脈、橈動脈全動脈化冠狀動脈旁路移植術的流量探討.山東大學學報(醫學版), 2013, 51(4): 47-50.
5.	Ferrari ER, Von Segesser LK. Artrial grafting for myocardial revascularization: how better is it? Curr Opin Cardiol, 2006, 21(6): 584-588.
6.	Pevni D, Mohr R, Lev-Ran O, et al. Technical aspects of composite arterial grafting with double skeletonized internal thoracic arteries. Chest, 2005, 123(5): 1348-1354.
7.	Cable DG, Caccitolo JA, Pearson PJ, et al. New approaches to prev-ention and treatment of radial artery graft vasospasm. Circulation, 1998, 98(19 Suppl): 1115-1122.
8.	陶登順, 汪曾煒, 王輝山, 等.內皮型一氧化氮合酶基因轉染防治移植靜脈再狹窄的實驗研究.中華外科雜志, 2005, 43(5): 657-658.
9.	陶登順, 王輝山.冠狀動脈旁路移植術后血管橋再狹窄的機制及防治現狀.心臟雜志, 2006, 18(5): 585-587.
10.	陶登順, 王輝山, 汪曾煒, 等.兔頸靜脈動脈化后血管的重塑機制.第四軍醫大學學報, 2006, 25(14): 1456-1458.
11.	Baskett RJ, Cafferty FH, Powell SJ, et al. Total artenal revasculariza-tion is safe: Multicenter ten-year analysis of 71, 470 coronary procedures. Ann Thorac Surg, 2006, 81(4): 1243-1248.
12.	Tranbaugh RF, Dimitrova KR, Friedmann P, et al. Radial artery conduits improve long-term survival after coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(4): 1165-1172.
13.	Hortmann HC, Oliveira HG, Rabello RR, et al. Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting postoperative with return of the symptoms. Rev Bras Cir Cardiovasc, 2010, 25(2): 218-223.
14.	Ivana P, Dusko N, Miodrag P, et al. Radial artery vs saphenous vein graft used as the second conduit for surgical myocardial revascularization: long-term clinical follow-up. J Cardiothorac Surg, 2015, 10: 127-133.
15.	Won-Chol C, Joon BK, Sung HJ, et al. Revascularization of the left anterior descending artery area using a single left internal thoracic artery: Auto-Y composite graftingor sequential bypassing. J Thorac Cardiovasc Surg, 2011, 142(6): 1464-1468．.
16.	萬峰, 王京生, 主編.現代冠心病外科治療學.北京:中國協和醫科大學出版社, 2003. 28-38．.
17.	Lemma M, Gelpi G, Mangini A, et al. Myocardial revascularization with multiple arterial grafts: comparison between the radial artery. Ann Thorac Surg, 2001, 71(6): 1969-1973.
18.	William R, Burfeind JR, Donald D, et al. Single versus multiple internal mammary artery grafting for coronary artery bypass: 15-year follow-up of a clinical practice trial. Circulation, 2004, 110(1): 1127-1135.
19.	Calafior AM, Di Giammarco G, Luciani N, et al. Composite artrial conduits for a wider artrial myocardial rvascularization. Ann Thorac Surg, 1994, 58(1): 185-190.
20.	Gaudino M, Di Mauro M, Iacò AL, et al. Immediat flow reserve of Y thoracic artry grafts' an intraoperative flow metric study. Thorac Cardiovasc Surg, 2003, 126(4): 1076-1079.

1. Toshihiro F, Minoru T, Masataka T, et al. Extensive reconstruction of the left anterior descending coronary artery with an internal thoracic artery graft. Ann Thorac Surg, 2011, 91(2): 445-451．.
2. Tranbaugh RF, Dimitrova KR, Friedmann P, et al. Coronary artery bypass grafting using the radial artery: clinical outcome patency and need for reintervention. Circulation, 2012, 126(11 Suppl 1): S170-S175.
3. Deb S, Cohen EA, Singh SK, et al. Radial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: result from RAPS (Radial artery patency study). Am Coll Cardiol, 2012, 60(1): 28-35.
4. 董明亮, 李清寶, 李德才, 等.非體外循環下左乳內動脈、橈動脈全動脈化冠狀動脈旁路移植術的流量探討.山東大學學報(醫學版), 2013, 51(4): 47-50.
5. Ferrari ER, Von Segesser LK. Artrial grafting for myocardial revascularization: how better is it? Curr Opin Cardiol, 2006, 21(6): 584-588.
6. Pevni D, Mohr R, Lev-Ran O, et al. Technical aspects of composite arterial grafting with double skeletonized internal thoracic arteries. Chest, 2005, 123(5): 1348-1354.
7. Cable DG, Caccitolo JA, Pearson PJ, et al. New approaches to prev-ention and treatment of radial artery graft vasospasm. Circulation, 1998, 98(19 Suppl): 1115-1122.
8. 陶登順, 汪曾煒, 王輝山, 等.內皮型一氧化氮合酶基因轉染防治移植靜脈再狹窄的實驗研究.中華外科雜志, 2005, 43(5): 657-658.
9. 陶登順, 王輝山.冠狀動脈旁路移植術后血管橋再狹窄的機制及防治現狀.心臟雜志, 2006, 18(5): 585-587.
10. 陶登順, 王輝山, 汪曾煒, 等.兔頸靜脈動脈化后血管的重塑機制.第四軍醫大學學報, 2006, 25(14): 1456-1458.
11. Baskett RJ, Cafferty FH, Powell SJ, et al. Total artenal revasculariza-tion is safe: Multicenter ten-year analysis of 71, 470 coronary procedures. Ann Thorac Surg, 2006, 81(4): 1243-1248.
12. Tranbaugh RF, Dimitrova KR, Friedmann P, et al. Radial artery conduits improve long-term survival after coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(4): 1165-1172.
13. Hortmann HC, Oliveira HG, Rabello RR, et al. Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting postoperative with return of the symptoms. Rev Bras Cir Cardiovasc, 2010, 25(2): 218-223.
14. Ivana P, Dusko N, Miodrag P, et al. Radial artery vs saphenous vein graft used as the second conduit for surgical myocardial revascularization: long-term clinical follow-up. J Cardiothorac Surg, 2015, 10: 127-133.
15. Won-Chol C, Joon BK, Sung HJ, et al. Revascularization of the left anterior descending artery area using a single left internal thoracic artery: Auto-Y composite graftingor sequential bypassing. J Thorac Cardiovasc Surg, 2011, 142(6): 1464-1468．.
16. 萬峰, 王京生, 主編.現代冠心病外科治療學.北京:中國協和醫科大學出版社, 2003. 28-38．.
17. Lemma M, Gelpi G, Mangini A, et al. Myocardial revascularization with multiple arterial grafts: comparison between the radial artery. Ann Thorac Surg, 2001, 71(6): 1969-1973.
18. William R, Burfeind JR, Donald D, et al. Single versus multiple internal mammary artery grafting for coronary artery bypass: 15-year follow-up of a clinical practice trial. Circulation, 2004, 110(1): 1127-1135.
19. Calafior AM, Di Giammarco G, Luciani N, et al. Composite artrial conduits for a wider artrial myocardial rvascularization. Ann Thorac Surg, 1994, 58(1): 185-190.
20. Gaudino M, Di Mauro M, Iacò AL, et al. Immediat flow reserve of Y thoracic artry grafts' an intraoperative flow metric study. Thorac Cardiovasc Surg, 2003, 126(4): 1076-1079.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Analysis of Left Ventrical Total Artery Revascularization with "T"-type Anasto-mosis of Left Internal Mammary Artery and Radial Artery on Pump

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content