Feasibility and suitability of the routine use of bilateral internal thoracic arteries.
BACKGROUND
It has been demonstrated that bilateral use of internal thoracic arteries (ITAs) confers better long-term results in patients than does unilateral use. However, routine use of bilateral ITAs has usually been avoided.


METHODS
Since 1997, we have used bilateral ITAs extensively for patients who required multivessel bypasses. Recently, 243 consecutive patients, including 127 diabetic patients, were reviewed.


RESULTS
Every patient received at least one ITA graft, and 200 patients (82%) received bilateral ITAs. The majority (93%) of ITA grafts were used as in situ grafts. The hospital mortality rate was 0.41%, and deep sternal infections were observed in 5 patients (2.0%). There was no difference in the incidence of chest wound infection between the group treated with bilateral ITA grafting and that treated by unilateral ITA grafting.


CONCLUSIONS
These observations suggest that ITAs can be used bilaterally for treatment in the majority of patients who require multivessel bypass, with low mortality and morbidity.
Hirotani
Takashi
T
hero.takashi@nifty.ne.jp
Shirota
Shogo
S
Cho
Yasunori
Y
Takeuchi
Shigeyuki
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation*; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate