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内胸動脈のスパスムに対する剥離法(skeletonized対pedicled)ならびに薬理学的前処置(パパベリン対オルプリノン)の実験的検討

By  Koji KOHNO

Abstract

内胸動脈の剥離法の優劣(skeletonized法とpedicle法),ならびに剥離血管の薬理学的前処置の優劣(パパベリンとオルプリノン)を,ブタを使った実験でそれぞれ比較検討した.内胸動脈の剥離法を比較した結果,harmonicscalpelを用いた完全skeletonized法は,pedicle法に比べて,より長いグラフト長の確保が可能であったが,剥離直後のスパスムによる血管径と血流量の減少がより大きかった.一方,薬理学的前処置の効果を比較した結果,血管径の増加効果は両薬間で差がなかったが,血流量の増加効果がオルプリノンの方がやや大きいことが判明した.また電子顕微鏡を用いた比較ではパパベリン群で内皮細胞の障害が多い結果であった.We compared skeletonized and pedicled internal thoracic artery (ITA) grafts in pigs, and compared papaverine versus olprinone for pretreatment of harvested blood vessels. Our results showed that the complete skeletonized technique using a harmonic scalpel assured a longer graft length than the pedicled technique. The skeletonized technique also resulted in a transient decrease in blood vessel diameter and blood flow volume due to spasms immediately following an artery harvest. Both pharmacological pretreatments showed no differences with respect to blood vessel diameter, but olprinone showed a slightly greater blood flow volume. Electron microscope showed a greater endothelial cell damage in the papaverine group

Topics: coronary artery bypass graft (CABG), harvesting of internal thoracic artery (ITA), ultrasonic scalpel (harmonic scalpel), phosphodiesterase III (PDE-III) inhibitor, olprinone
Publisher: 東京女子医科大学学会
Year: 2007
OAI identifier: oai:ir.twmu.ac.jp:10470/27371
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