Early clinical and angiographic outcome of the pedicled right internal thoracic artery graft to the left anterior descending artery.
BACKGROUND
The left internal thoracic artery (LITA) graft to the left anterior descending (LAD) artery became the gold standard graft in coronary surgery. Subsequently, the right internal thoracic artery (RITA) graft was increasingly used. However, there is still some debate about the optimal way of using this conduit. The aim of the present study was to assess our experience in grafting the pedicled RITA graft to LAD in 212 consecutive patients.


METHODS
The records of 212 consecutive patients who underwent isolated coronary artery bypass grafting with the pedicled RITA graft to the LAD artery at Harefield Hospital between January 1998 and May 2001 were retrospectively reviewed. We approached the last 35 consecutive patients to obtain an angiographic control group. All 35 patients (16.5%) consented and, before discharge, underwent angiography to look at the quality of anastomoses and the patency of grafts.


RESULTS
Successful catheterization and engagement of the RITA grafts was performed in 32 patients. Angiography showed that 32/32 (100%) of the RITA grafts were widely patent with excellent flow. The distal anastomoses of these RITA grafts were also satisfactory. There were no deaths among the study patients.


CONCLUSIONS
Our results show that the use of the pedicled RITA graft to the LAD artery provides a good early clinical and angiographic outcome, and suggests that the pedicled RITA graft to the LAD artery is a good alternative to the pedicled LITA graft to the LAD artery.
Al-Ruzzeh
Sharif
S
National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Harefield Hospital, Middlesex, United Kingdom.
George
Shane
S
Bustami
Mahmoud
M
Nakamura
Koki
K
Ilsley
Charles
C
Amrani
Mohamed
M
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001158:Arteries / Q000637:transplantation*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014654:Vascular Patency / Q000502:physiology