[Use of the internal mammary artery as a free graft with reimplantation of the proximal end onto the ascending aorta. Apropos of 39 cases].
From January 1987 to January 1991, 104 patients received bilateral internal mammary artery grafts and 39 of them had coronary bypass with a free graft implanted on the ascending aorta. There were 35 men, with a mean age of 57.35 years (range 41 to 70 years). 87% of them had stable angina, and 23 had preoperative myocardial infarction. The left ventricular function was good in 77 per cent of cases. 23 patients had three vessel disease (61.5%), 13 two vessel diseases (30.7%), 2 one vessel disease (5.12%) and one a left main coronary stenosis. Left internal mammary artery was used in two patients on the left descending artery and the right internal mammary artery was used in 37 patients: 15 on the circumflex, 15 on the right coronary, 4 on the LDA and 3 on the diagonal artery. Five patients had one graft, 32 two grafts and one three grafts (bilateral mammary and saphenous vein). Hospital mortality was 2.56% (1 patient) and there were 2 late deaths (5.12%). There were 5 perioperative myocardial infractions (12.8%) and no sternal infections. The mean follow up is 21 months (range 3 to 46 months). At follow-up, 34 patients (87.2%) were asymptomatic, and there were no myocardial infarctions. Postoperative angiography in 8 patients (mean postoperative time 2.5 months) showed that all the grafts were patent. This analysis demonstrates that free IMA graft has a low operative risk and provides excellent long term functional improvement and survival.
Service de Chirurgie Thoracique et Cardio-Vasculaire A, Hôpital Cardiologique, Bron.
J
J
Robin
J M
JM
Zabot
A
A
Eker
C
C
Diab
D
D
Revel
J F
JF
Chassignolle
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000601:surgery; D001011:Aorta / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*
Utilisation de l'artère mammaire interne comme greffon libre avec réimplantation de l'extrémité proximale sur l'aorte ascendante. A propos de trente-neuf cas.