Current Trends in Surgical Revascularization of Multivessel Coronary Artery Disease With Arterial Grafts
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- Nicolini Francesco
- Cardiac Surgery Unit, Department of Clinical and Experimental Medicine, University of Parma
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- Agostinelli Andrea
- Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital
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- Spaggiari Igino
- Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital
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- Vezzani Antonella
- Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital
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- Benassi Filippo
- Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital
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- Maestri Francesco
- Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital
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- Gherli Tiziano
- Cardiac Surgery Unit, Department of Clinical and Experimental Medicine, University of Parma
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抄録
It is well known that graft patency determines prognosis in coronary artery bypass grafting. Numerous reports over the past 20 years have documented superior patency and prognosis when multiple arterial grafts are used. The use of the left internal thoracic artery to graft the left anterior descending artery has been widely accepted as the gold standard for surgical treatment of coronary disease for over 40 years. A considerable body of evidence suggests that the right internal thoracic artery behaves in the same way. Radial artery grafts are being studied in several randomized trials, but observational studies suggest a performance comparing favorably with the saphenous vein. The right gastroepiploic artery has been recognized as a suitable and reliable conduit for coronary bypass surgery. However, the use of multiple other arterial grafts is performed in less than 10% of surgical procedures, probably because of perceptions of technical complexity, prolonged time for conduit harvesting, and increased perioperative complications. As a result, most patients with multivessel coronary artery disease do not benefit from extensive revascularization with arterial conduits. The aim of this review is to summarize the current evidence for the extensive use of arterial conduits in the revascularization of multivessel coronary artery disease.
収録刊行物
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- International Heart Journal
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International Heart Journal 55 (5), 381-385, 2014
一般社団法人 インターナショナル・ハート・ジャーナル刊行会