12．CABGグラフト採取法（内胸動脈，橈骨動脈，胃大網動脈，大伏在静脈）

Techniques of Graft Harvesting for Coronary Revascularization

日本冠動脈外科学会が行った2020年の全国調査によると，わが国の冠状動脈バイパス術（CABG）で使われているグラフト選択の内訳は，右内胸動脈（RITA）17％，左内胸動脈（LITA）42％，大伏在静脈（SVG）35％，右胃大網動脈（GEA）3％，橈骨動脈（RA）3％であった1）．すなわち，内胸動脈（ITA）だけでグラフト全体の約6割を，さらにSVGを加えると94％をまかなえてしまうことがわかる．本稿では使用頻度の高い順番に，筆者の行っているグラフト採取方法を紹介する．

In Japan, the vascular grafts employed in coronary artery bypass surgery comprised 69％ internal thoracic artery, 35％ great saphenous vein, 3％ right gastroepiploic artery, and 3％ radial artery. Graft harvesting for coronary artery bypass grafting is deemed the foundational skill to be mastered in cardiovascular surgery training and is frequently executed by novice surgeons. However, while redoing the anastomosis is relatively straightforward, repairing a damaged graft is exceedingly challenging. Specifically, if the internal thoracic artery is compromised and rendered unusable, it can adversely impact the patient’s prognosis. We aspire that this article aids each of you in establishing a safe and reliable graft harvesting technique.