Similar hospital morbidity with the use of one or two internal thoracic arteries.
The hospital morbidity and mortality of 100 patients operated with two internal thoracic arteries with or without additional vein grafts (BITA group) were compared with a matched group of 100 patients operated with one left internal thoracic artery (ITA) on the anterior descending artery with additional vein grafts (LITA control group). In each study group, 3% of the patients had diabetes mellitus. There was no statistical significant difference in hospital mortality (1% versus 0%), perioperative myocardial infarction (5% versus 1%), low cardiac output (3% versus 5%), rethoracotomy (1% versus 0%), lung complications (13% versus 13%), wound complications (8% versus 8%), other cardiac complications (26% versus 16%), other noncardiac complications (1% versus 4%), median duration of stay in the intensive care unit (1 versus 1 day), and mean duration of stay in the hospital (10.4 versus 10.8 days) between the groups. Logistic regression analysis showed that the number of ITAs used was not a predictor of complications. Thus, there is no difference between the BITA and LITA control group in hospital mortality and morbidity (in patients with a low incidence of diabetes). If an improvement in cardiac event-free and reoperation-free survival is to be expected, the use of both ITAs can be continued in similar patients.
Department of Cardio-pulmonary Surgery, Catharina Hospital, Eindhoven, The Netherlands.
E
E
Berreklouw
J P
JP
Schönberger
J H
JH
Bavinck
V J
VJ
Verwaal
E L
EL
Koldewijn
F
F
van der Linden
I
I
van der Tweel
J J
JJ
Bredée
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002303:Cardiac Output, Low / Q000209:etiology; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D003422:Critical Care; D005260:Female; D006324:Heart Arrest, Induced; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D015996:Survival Rate; D013895:Thoracic Arteries / Q000637:transplantation*