Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation.
BACKGROUND
This review presents an overview of interventional revascularization procedures of the internal thoracic artery after prior implantation as a coronary-artery bypass graft.


METHODS
Our search was concentrated on the MEDLINE-database to identify all articles on internal thoracic artery-graft-angioplasties and reoperation after internal thoracic artery bypass grafting published between 1968 and 2000.


RESULTS
Surgical revascularization and reoperation were reported in five papers including a total of 785 patients. The overall mortality of these patients was 4.2%. The presence of a patent internal thoracic artery-graft at the time of reoperation was not a risk factor for higher morbidity and mortality. Revascularization with percutaneous transluminal coronary angioplasty of the internal thoracic artery or the native left anterior descending artery via the internal thoracic artery-graft used as a conduit was performed in 327 patients. The primary success rate was 87%, the angiographically assessed rate of restenosis was 30% and the rate of complications approximately 1%.


CONCLUSIONS
In spite of technical problems the percutaneous transluminal coronary angioplasty in or via internal thoracic artery-graft presents a safe and feasible option to be recognized before a potential reoperation.
Marx
Roger
R
Heart Center Wuppertal, Department of Cardiology, University of Witten-Herdecke, Gotenstrasse 1, 42653 Solingen, Germany. RogerMarx@t-online.de
Klein
Rolf-Michael
RM
Horlitz
Marc
M
Ketteler
Thomas
T
Schannwell
Christiana Mira
CM
Lapp
Harald
H
Gülker
Hartmut
H
D000800:Angioplasty, Balloon / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008323:Mammary Arteries / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation