[
Abstract]
[
Full Text PDF] （in Japanese / 3457KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 86(5): 613-618, 1985
Original article
THE EFFECTS OF AORTO-CORONARY BYPASS GRAFTING TO TOTALLY OCCLUDED CORONARY ARTERIES ON LEFT VENTRICULAR CONTRACTILITY
The effects of aorto-coronary bypass grafting (ACBG) on totally occluded coronary arteries (TOCA), postocclusion vessels of which were demonstrated angiographically through collafterals and left ventricular contractility were studied in eleven patients consisted of nine with transmural myocardial infarction (TMMI) on ECG in the area perfused by TOCA and without TMMI. Of eleven ACBG consisting of eitht left anterior descending coronary arteries (LAD) and three right coronary arteries (RCA), all eight grafts to LAD were patent, whereas two of three to RCA were obstructed on the postoperative angiogram. The following evaluations were undertaken in the cases with patent grafts. In seven cases with TMMI (six LAD, one RCA), left ventricluar ejection fraction (EF) increased from 0.56±0.08 (Mean±SD) to 0.65±0.07 (p＜0.01). PLVSP/LVESV slishtly increased, but not significantly. Mean Vcf increased from 1.07±0.33 to 1.83±0.88 circ/sec (p＜0.02). Left ventricular segmental wall motion also improved from 23.1±6.8 to 29.5±7.2% (p＜0.01), markedly in the anterior and apical segment. In two cases without TMMI, all of EF, PLVSP/LVESV, Mean Vcf and segmental wall motion improved much more than the cases with TMMI.
In conclusion, it was suggested that ACBG to TOCA, especially LAD visualized angiographically thorugh collaterals resulted in the excellent graft patency rate and th significant improvement of left ventricular contracyility, even in the cases with TMMI.
To read the PDF file you will need Adobe Reader installed on your computer.