[Sequential revascularization of anterior myocardium using the internal mammary artery. A year-long clinical and angiographic follow-up].
One hundred and twenty-one consecutive patients (104 men, 17 women; mean age 56 +/- 7.8 years) underwent sequential mammary artery grafting for anterior (left anterior descending or diagonal arteries) wall revascularisation. There was one death (0.8%) and five myocardial infarctions (4.2%) including two anterior infarcts during the first 30 postoperative days. All survivors were reviewed at one year. Of these 120 patients, 77 (64%) accepted control coronary angiography on average 456 +/- 143 days after surgery. One internal mammary artery anastomosed to 2 diagonal arteries was occluded. All the other latero-lateral anastomoses were patent. There was, however, one 60% stenosis. Three termino-lateral anastomoses on the left anterior descending artery were occluded and 2 others stenosed (40% and 60% luminal narrowing, respectively). Four internal mammary arteries were narrowed 2 because of stenosis and 2 because of the small calibre of the receiving artery. The patency rate considering the total number of anastomoses was therefore 96.8%. These results show that sequential internal mammary artery grafting for myocardial revascularisation does not increase the number of perioperative complications and is associated with a low rate of occlusion on the left anterior descending artery at one year. This surgical technique may therefore be used routinely.
Services de cardiologie et de chirurgie cardiaque, CHU Morvan, Brest.
J
J
Mansourati
J J
JJ
Blanc
L
L
Genet
J
J
Boschat
M
M
Gilard
P
P
Penther
D
D
Deredec
P
P
Mondine
J A
JA
Barra
D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012307:Risk Factors
Revascularisation séquentielle du territoire myocardique antérieur au moyen de l'artère mammaire interne. Suivi clinique et angiographique à 1 an.