【摘要】 目的:模拟右冠状动脉弥散性狭窄并使用右乳内动脉(RIMA),建立选择性心中静脉动脉化(CVBG)模型。方法:对14只小型猪应用高胆固醇饮食结合右冠状动脉多节段内膜剥脱术,诱发形成右冠状动脉重度弥散性狭窄。随机均分为对照组及实验组,在非体外循环下使用RIMA对实验组实施CVBG,对照组则进行单纯开胸术。术后6 h行冠状动脉造影、超声心动图、桥血管流量监测及非放射性彩色微球法检测心肌各层血流量等检查。结果:6只小型猪成功建立了CVBG模型。实验组缺血心肌经再灌注后平均血流量较对照组显著改善[(0.33±0.05)vs.(0.19±0.03)mL.g-1.min-1,P<0.05],实验组的心功能较对照组明显好转[(0.51±0.06)vs.(0.43±0.06),P<0.05]。结论:通过高胆固醇饮食结合右冠状动脉多节段内膜剥脱术,诱导右冠状动脉重度弥散性狭窄,使用RIMA与心中静脉吻合成功建立了CVBG模型,并初步证明CVBG可改善心肌缺血,具有进一步研究价值。更多还原

【Abstract】 Objective:To build a selective coronary vein bypass grafting(CVBG)animal model by using of right internal mammary artery(RIMA) on basis of right severely diffuse coronary diseases.Methods:Severely diffuse diseases of right coronary artery were produced by breeding high-cholesterol food combined with right coronary endarterectomy in multi-positions in 14 swine.The swine with serious diffuse right coronary diseases were randomly divided into control and experiment groups.Off-pump CVBG were performed by anastomosing RIMA with middle cardiac vein in the experiment group.The control group received thoracotomy.Coronary angiography,graft flow,echocardiography and myocardial blood flow with non-radioactive colored microspheres were done or measured 6 hours after operations.Results:CVBG were successfully performed in six swine in the experiment group.There were significant improvements in myocardial flow[(0.33±0.05) vs.(0.19±0.03) mL·g-1·min-1,P<0.05] and cardiac function [(0.51±0.06) vs.(0.43±0.06),P<0.05] in the experiment group compared with the control group.Conclusion:Severely diffuse right coronary diseases can be produced by breeding high-cholesterol food combined with right coronary endarterectomy in multi-positions.CVBG model can be established by anastomosing RIMA with middle cardiac vein.Ischemic conditions of myocardium can be relieved by CVBG which is worthy of further study.更多还原