Complete arterial coronary artery bypass grafting versus conventional revascularization--early results.
BACKGROUND
Complete arterial coronary artery bypass grafting (CABG) offers the potential to improve long-term results. However, an increased perioperative risk has been controversially discussed. New operative techniques (skeletonization of the ITA/ T-grafts/utilization of the radial artery (RA)) may decrease perioperative risk. We compared the outcome after conventional with that after complete arterial CABG.


METHODS
Three consecutive groups of patients were analyzed. In group I (n = 50), CABG was performed using left ITA and vein grafts. The other two groups received complete arterial CABG with either both ITA's (group II; n = 52) or left ITA and RA (group III; n = 52).


RESULTS
A mean of 3.9+/-0.8 (I) versus 4.2+/-0.8 (II) and 3.9+/-0.9 (III) anastomoses were performed per patient (ns). Mean operating time was significantly prolonged in group II (II: 252+/-54; p<0.0001; vs. I: 191+/-36; III: 203+/-33). Mean ischemic time was significantly prolonged in group II and III (II:65+/-20; p<0.0001; III: 68+/-16; p<0.0001; vs. I: 51+/-15). Mean bypass time (I: 83+/-23; II: 95+/-41; III: 91+/-21), the rate of postoperative complications and in-hospital mortality (I: n = 0; II: n = 2; III: n = 0; ns) showed no significant differences.


CONCLUSIONS
Complete arterial CABG using modern surgical techniques is as safe as the conventional surgical approach using left ITA and vein graft.
Wendler
Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg/Saar, Germany. chowen@med-rz.uni-sb.de
Shahangi
E
E
Georg
T
T
Schäfers
H J
HJ
D000704:Analysis of Variance; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome