Levent YAZICIOĞLU, Hakkı AKALIN, Atilla ARAL

İnternal mammarian arter greftlerinde ateroskleroz gelişimi

Çalışmanın Amacı İMA'ların histopatolojik özelliklerini irdeleyerek atheroskleroza karşı korunduğunu vurgulamaya çalışmaktır. Çalışma A.Ü.T.F. KVC Anabilim Dalı'nda Mayıs 1997-Kasım 1997 tarihlerinde CABG uygulanan 50 hasta üzerinde gerçekleştirilmiştir. Hastaların 36'sı erkek, 14'ü kadın ve ortalama yaş 59.6 ± 6.3 idi. Preoperatif dönemde tüm hastalara bilateral renkli Doppler İMA USG'si yapılmıştır. Peroperatif LİMA'lardan histopatolojik inceleme için biopsi örnekleri alınmıştır. Preoperatif renkli Doppler USG incelemelerinde İMA'larda akımı bozan, stenoza yol açan herhangi bir atherosklerotik bulguya rastlanmamıştır. İMA örneklerinin histopatolojik değerlendirilmesinde 48 hastada düzenli bir elastik arter yapısı görülmüştür. Diğer 2 hastada intimada yağ dolu histiositlerin oluşturduğu, akımı bozmayan yağlı çizgiler izlenmiştir. Minimal atherosklerotik değişiklikler serimizde %4 olarak bulunmuştur. Sonuç olarak İMA'larda atherosklerotik değişikliklerin daha az geliştiği belirlenmiştir.

Development of atherosclerosis in IMA grafts

The aim of this study is to evaluate the IMA grafts hystopathologically and to determine its prevention against atherosclerosis. Fifty patients who had undergone CABG operation on May 1997-October 1997 in Ankara University Medical School Department of Cardiovascular Surgery were included in this study. Mean age of the 36 male and 14 female patients was 59.6 ± 6.3 years. All patients were evaluated by bilateral colour Doppler IMA USG preoperatively. Peroperatively IMA specimens for hystopathologic examination were taken. Preoperative colour Doppler USG evaluation of IMA showed no evidence of stenosis or flow obstruction and atherosclerosis. Hystopathologic examination of 48 IMA specimens showed regular elastic artery features. The intimal layer of the other 2 specimens was seen to involve foam cells which formed fatty streaks taht didn't form luminal irregularity. The incidence of minimal atherosclerotic lesions were 4%. In conclusion it has been determined that atherosclerotic alterations develop minimally on the IMA grafts.

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