両側内胸動脈を用いた冠動脈血行再建術の経験

Experience of double internal thoracic artery grafts in coronary artery revascularization

　われわれは，昭和63年2月より冠動脈血行再建術に対して両側内胸動脈をグラフトとして用いている。以来1年3カ月の間に，7例の症例に両側内胸動脈を用いた。年齢は55歳〜67歳（平均60.6歳）で，男性が6例，女性は1例であった。術前狭心症のCCS重症度分類では，Class Ⅰが1例，Class Ⅱが1例，Class Ⅲが4例，Class Ⅳが1例であった。手術死亡はなく，退院時のCCS分類では，Class Ⅰが6例Class Ⅱが1例であった。グラフトの開存性も良く，検査し得た6例すべてに，退院時グラフトの開存を確認した。本法は，適応を選べば，特にriskを増加させずに安全に行える方法と考える。

We have started employing two internal thoracic artery grafts in coronary artery revascularization since February 1988. We have carried out seven such operative procedures in a 15 month period since then. Ages ranged from 55 to 67 years with a mean of 60.6. Six patients were male and one patient was female. One patient was in Canadian Cardiovascular Society angina Class Ⅰ ,one in Class Ⅱ, four in Class Ⅲ, and one in Class Ⅳ, preoperati-vely. There were no operative deaths. Postopera-tively, six patients were in CCS Class Ⅰ and one was in Class Ⅱ. All of the internal thoracic artery grafts were patent at hospital discharge in six angiographically examined patients. We feel that use of double internal thoracic artery grafts in coronary revascularization carries minimal additional risk, when performed in selected case.