CABG: Arterial Grafts, Blood Flow and Sternal Care | Part 2 | 心血管 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字;遇到過度簡化或舊門檻,請搭配下方提示與原始資料閱讀。這是概念學習材料,不替代個別醫療評估。

Lyrics · 完整歌詞

In cardiogenic shock, recent ticagrelor is no reason to wait,
because lost blood can be replaced while infarcted muscle cannot,
and four lines close the station.

All arterial conduits outlast veins because their endothelium secretes nitric oxide
and prostacyclin,
so the mammary artery to the LAD is the golden graft.
Is the patient diabetic, obese or elderly?
Then one mammary artery, not two,
protects the sternum from deep wound infection.
On Poiseuille's law, flow varies with the fourth power of the radius,
so a halved radius leaves one sixteenth of the flow.
Lumen for lumen,
a radial graft needs a target stenosis of at least 70 per cent,
and a shocked heart needs surgery now, not in five days.


All arterial conduits outlast veins because their endothelium secretes nitric oxide
and prostacyclin,
so the mammary artery to the LAD is the golden graft.
Is the patient diabetic, obese or elderly?
Then one mammary artery, not two,
protects the sternum from deep wound infection.
On Poiseuille's law, flow varies with the fourth power of the radius,
so a halved radius leaves one sixteenth of the flow.
Lumen for lumen,
a radial graft needs a target stenosis of at least 70 per cent,
and a shocked heart needs surgery now, not in five days.

Medical Notes · 醫學學習提示

  1. 心因性休克須緊急再灌流;依病況選 PCI 或繞道手術
  2. 近期用藥增加出血風險;須與延誤再灌流的風險權衡
  3. 掌握移植物選擇、傷口風險、管徑與再灌流時機
  4. 動脈移植物常具較佳通暢率;並非每條都優於靜脈
  5. 一氧化氮與前列環素有助血管舒張、抑制血小板
  6. 左內胸動脈接左前降支,是常用的優先繞道選擇
  7. 糖尿病、肥胖等須評估胸骨傷口風險;年齡非唯一依據
  8. 是否採雙側內胸動脈須個別評估,並非一律禁用
  9. 骨骼化取材與血糖控制,可協助降低胸骨傷口風險
  10. 理想層流下:壓差、黏度、長度固定,流量正比半徑四次方
  11. 同樣假設下,半徑減半:流量為原來 1/16;圖為示意
  12. 移植物選擇需考慮目標血管、競爭血流及患者條件
  13. 橈動脈宜接高度、近閉塞狹窄;70% 並非通用門檻
  14. 休克須緊急再灌流,不一定開刀;擇期停藥時程另評估

References