Myocardial revascularization using both attached internal thoracic arteries. Mid-term clinical evaluation of 117 cases.
The current trend in myocardial revascularization is to use arterial grafts in most, if not all cases. The right internal thoracic artery was a logical choice once the left internal thoracic artery patency on the LAD was known. This study presents our experience of using both attached internal thoracic arteries (ITA). Between January and October 1990, 159 myocardial revascularizations were performed in our department. In 117 cases, bilateral ITA grafting was used with non exclusion criteria. There were 100 male and 17 female patients, with a mean age of 61 +/- 8. The LITA was anastomosed to the LAD in 44 cases, and to the marginal artery in 74. The RITA was anastomosed to the LAD in 68 cases, to the marginal artery in 47 and to the right coronary artery in 2. An average of 3.5 bypasses per patient, including saphenous vein grafts, were performed. Six patients (5%) died within 30 days. Four patients (3.4%) were diagnosed as having periperative myocardial infarcts. There were no reoperations for bleeding. One patient (0.9%) presented a sternal wound infection. Mean follow-up was 18 +/- 7 months. Six patients died during the follow-up and the survival rate was 91%. Ninety-five patients (91%) were symptom-free, 9 patients had a recurrent angina. Postoperative coronary angiography was performed in 11 patients (10%).(ABSTRACT TRUNCATED AT 250 WORDS)
Chocron
S
S
Department of Thoracic and Cardiovascular Surgery, Hôpital Saint-Jacques, Besançon, France.
Alwan
K
K
Clement
F
F
Cordier
A
A
Chipman
N S
NS
Taberlet
C
C
Etievent
J P
JP
D000368:Aged; D000787:Angina Pectoris / Q000601:surgery*; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D009204:Myocardial Revascularization; D009765:Obesity; D012307:Risk Factors; D012907:Smoking