Results of coronary artery bypass grafting using multiple arterial conduits.
Between January 1991 and June 1993, a total of 128 patients underwent coronary artery bypass grafting employing multiple autologous arterial conduits, including 157 internal mammary arteries, 69 inferior epigastric arteries, 44 gastroepiploic arteries, and 72 radial artery grafts. Their mean age was 61.4 years (range 29 to 82 years). The patients were divided into 2 groups: group A, consisted of 69 patients (mean age 60.3 years), in whom multiple arterial conduits were used exclusively (no vein grafts); group B, included 59 patients (mean age 62.7 years) in whom, in addition to multiple arterial conduits, 89 saphenous vein grafts were used concomitantly. The mean number of grafts was 3.1 and 3.7, for groups A and B, respectively. The preoperative left ventricular function, and the prevalence of unstable angina, a recent myocardial infarction, and diabetes, were not significantly different between both groups. Our series included 11 "redo" operations (8 in group A, and 3 in group B). There were 6 early deaths (4.7% mortality) (1 in group A, and 5 in group B), and 4 perioperative myocardial infarctions (1 in group A, 3 in group B). During a mean follow-up of 12.9 months (range 1 to 28 months) there were no late deaths or reoperations in any group. All patients in group A are free of symptoms. In group B, 2 patients have recurrent angina, and 1 had a late myocardial infarction, in the distribution of a vein graft. A myocardial SPECT scan with exercise revealed new perfusion defects in 4 of 49 patients (1 in group A, 3 in group B), studied 1 year after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Dietl
C A
CA
Department of Cardiovascular Surgery, Geisinger Medical Center, Danville, Pennsylvania 17822-1343.
Madigan
N P
NP
Menapace
F J
FJ
Lasek
C
C
Bering
J P
JP
Henry
S D
SD
Pamfilis
S M
SM
Telesford
L A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation