1、Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiog
2、ram and ICU of our own, and nearly 1,000 case of operation was completed annually.,CAGB术桥血管的选择与评估,Introduction,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the la
3、rgest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,01,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, t
4、ake the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Internal ThoracicArt
5、ery,02,Radial Artery,03,GastroepiploicArtery,04,Greater SaphenousVein,CONTENTS,1. Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic
6、cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is th
7、e largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Kolessov施行了第一台成功的ITA冠状动脉搭桥计划手术。,Goetz施行了第一台成功的CAGB计划手术使用金属管道连接RITA与RCA。,Longmire在冠状动脉内膜切除术失误时，被迫临时行ITA
8、-coronay手术，是直接使用ITA行CAGB的第一例。,Arthur Martin Vineberg将ITA移植入心肌隧道，利用其侧支出血，改善心脏血运，死亡率6%。,History,Internal Thoracic Artery,抗动脉粥样硬化,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surger
9、y. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Internal Thoracic Artery,独特的内皮,Cardiavascular Surgery Department of our 1st Hospital of La
10、nzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation
11、was completed annually.,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthes
12、ia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry
13、 out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,术前的乳内动脉造影B超术中游离乳内动脉，术中观察,评估方法,Internal Thoracic Artery,Cardi
14、avascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram a
15、nd ICU of our own, and nearly 1,000 case of operation was completed annually.,Pedicled,Skeletonization,vs,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular su
16、rgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,The Journal of Thoracic and Cardiovascular Surgery c July 2016,Pedicled and skeletoniz
17、ed single and bilateral internal thoracic artery grafts and the incidence of sternal wound complications: Insights from the Arterial Revascularization Trial (2056 patients/1year),University of Bristol & University of Oxford & Medical University of Gdansk & Norfolk and Norwich University Hospitals NH
18、S Foundation Trust,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, e
19、xtracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,The Journal of Thoracic and Cardiovascular Surgery c July 2016,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was found
20、ed in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Th
21、e Journal of Thoracic and Cardiovascular Surgery c July 2016,Internal Thoracic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in o
22、ur province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,The Journal of Thoracic and Cardiovascular Surgery c July 2016,1、双侧带蒂游离的术后胸骨并发症明显多于单侧带蒂游离；2、单侧或双侧骨骼化较单侧带蒂游离无明显差异；3、双侧带蒂游离为胸骨并发症的危险因
23、素，对糖尿病患者及肥胖患者尤为显著。,1、双侧带蒂游离的术后胸骨并发症明显多于单侧带蒂游离；2、单侧或双侧骨骼化较单侧带蒂游离无明显差异；3、双侧带蒂游离为胸骨并发症的危险因素，对糖尿病患者及肥胖患者尤为显著。,2. Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulat
24、ion, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Radial Artery,Originally described by Carpentier and associates in the early 1970s,32%,grafts occluded at 2 years,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was
25、founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annuall
26、y.,Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, u
27、ltrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the
28、 largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,评估方法,术前评估：超声、血管造影临床检查：触诊搏动是否良好、Allen 试验评估同侧尺动脉代偿能力取非优势前臂的桡动脉,Radial Artery,Cardiavascular Surgery Depar
29、tment of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and
30、nearly 1,000 case of operation was completed annually.,Comparison of Radial Artery and Saphenous Vein Graft Stenosis More Than 5 Years After Coronary Artery Bypass Grafting (326 patients),University of Toronto & Sunnybrook Research Institute & University Health Network,Copyright 2016 by The Society
31、of Thoracic Surgeons,Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorpo
32、ral circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,就狭窄率而言，RA与SVGs在术后5年无明显差异。,Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carr
33、y out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Petrovic et al. Journal of Cardiothoracic Surgery (2015) 10
34、:127,Radial artery vs saphenous vein graft used as the second conduit for surgical myocardial revascularization: long-term clinical follow-up (200 patients/8years),Belgrade University School of Medicine, Belgrade, Serbia,Radial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou
35、University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was co
36、mpleted annually.,Petrovic et al. Journal of Cardiothoracic Surgery (2015) 10:127,Fig. 1 Kaplan-Meier curve for total mortality. Abbreviations,Fig. 2 KaplanKaplan-Meier curve for long-term clinical outcomes (composite of cardiac death, non-fatal myocardial infarction and repeat revascularization).,R
37、adial Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultra
38、sonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Petrovic et al. Journal of Cardiothoracic Surgery (2015) 10:127,就临床预后而言，RA与SVGs在术后8年无明显差异。,3. Gastroepiploic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University Now is the l
39、argest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Gastroepiploic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was fou
40、nded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,
41、Gastroepiploic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulati
42、on, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Gastroepiploic Artery,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surger
43、y. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,评估方法,多排螺旋CT，平均管径在 2mm 以上时可用于CABG。,Gastroepiploic Artery,Cardiavascular Surgery Department
44、of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly
45、 1,000 case of operation was completed annually.,Copyright 2015 by the International Society for Minimally Invasive Cardiothoracic Surgery,Fasudil Is an Effective Graft Vasodilator for Gastroepiploic Artery in Coronary Artery Bypass Grafting (30 patients),Kanazawa University Graduate School of Medic
46、al Science,4. Greater Saphenous Vein,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was
47、completed annually.,Greater Saphenous Vein,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, ex
48、tracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,Greater Saphenous Vein,易游离、即时可得、多用途、一定的抗痉挛性、无可比拟的血管长度主要缺点是随时间推移而加重的血管退变,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s,
49、take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,虽有不足但仍为最常用的桥血管之一,Gr
50、eater Saphenous Vein,Cardiavascular Surgery Department of our 1st Hospital of Lanzhou University was founded in the 1950s, take the lead in Northwest China to carry out the cardiavascular surgery. Now is the largest cardiac center in our province, we have team of anesthesia, extracorporal circulation, ultrasonic cardiogram and ICU of our own, and nearly 1,000 case of operation was completed annually.,
