[Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up].
BACKGROUND
Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries.


OBJECTIVE
To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one.


METHODS
A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose.


RESULTS
Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60).


CONCLUSIONS
The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event
López Rodríguez
F J
FJ
Servicios de Cirugía Cardiovascular. Hospital General Universitario Gregorio Marañón, Madrid. jlopezro@wanadoo.es
Voces
R
R
Lima
P
P
Reyes
G
G
Silva
J
J
Ruiz
M
M
Rico
M
M
González De Diego
F
F
Fortuny
R
R
Garrido
G
G
González Santos
J M
JM
Albertos
J
J
Fernández Calella
D
D
Vallejo
J L
JL
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors