[One year results of sequential mammary artery anastomoses. 120 clinical cases. Angiographies: 71 patients].
From 1985 to november 1989, 270 patients underwent sequential anastomosis with left internal mammary artery (LIMA) on left descending artery (LDA) and diagnonal artery (DA). The first 120 cases have 100% one year follow-up. The perioperative status was: angina stage III or IV: 59%; myocardial infarction (MI): 45%, stenosis of 3 vessels: 52.5%; stenosis of main coronary artery: 10.8%. 2.25 anastomoses were performed per patient. Side-to-side anastomosis (kissing) were not diamond anastomoses but axial and longitudinal. The use of fibrin gllude provides regular curves of the graft between anastomosis. Mortality was 0.8%, morbidity was: MI: 4.2% (2 small infarcts in anterior vessels, 3 others in non-grafted vessels); mediastinitis: 1%; severe bleeding (reoperation): 1%. At one year 93% of patients are free from angina and 71 patients underwent angiographic assessment (145 LIMA anastomosis). Results are as follow: side-to-side anastomosis patency: 98.5%; distal anastomosis obliteration: 3%; LDA anastomosis patency: 95.7% overall sequential anastomosis patency: 97.6%. These results have led our cardiologist in Brest to naturally prefer a surgical approach than percutaneous angioplasty when LDA and DA are involved.
Barra
J A
JA
Service de Chirurgie Thoracique et Cardio-Vasculaire, Centre Hospitalier Régional, Brest.
Mondine
P
P
Mansourati
J
J
Mahlab
A
A
Rukbi
I
I
Blanc
J J
JJ
Boschat
J
J
Genet
L
L
Etienne
Y
Y
Penther
P
P
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000379:methods*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011182:Postoperative Care; D011183:Postoperative Complications
Résultats à un an des anastomoses mammaires séquentielles. Cliniques: 120 cas--Angiographies: 71 patients.