[Myocardial revascularization of the anterior descending coronary artery with left internal mammary artery by means of extracorporeal circulation: 10 years follow-up].
BACKGROUND
The use of left internal mammary artery (LIMA) as a graft to anterior descending artery (LAD) has been associated with better long term results in coronary surgery.


OBJECTIVE
To assess and report the long-term results of LIMA to LAD bypass grafting for isolated LDA lesions.


METHODS
Retrospective analysis of the medical records and surgical protocols of 40 patients (aged 60+/-10 years, 28 male) subjected to coronary surgery between 1992 and 2002.


RESULTS
Thirty-four patients presented with unstable angina. On angiography, the LAD had a proximal obstruction in 35 patients. Sixteen presented with a myocardial infarction of the LAD territory. Six were managed previously with angioplasty; four had a new critical obstruction, 1 was catalogued as a procedure failure, and one was totally occluded. There was no operative mortality, myocardial infarction, stroke or need for re operation. There were two late deaths, caused by an advanced cardiac failure at 120 months in one patient, and chronic renal failure at 61 months of follow-up in another. Actuarial survival probability was 100%, 93% and 75% at 1, 5 and 10 years. Probability of freedom from angina was 98%, and freedom of suffering a new myocardial infarction was 100% at more than 10 years. The probability of no need for a new coronary procedure (angioplasty or surgery) also was 100% at more than 10 years.


CONCLUSIONS
The use of LIMA as a coronary bypass graft to LAD is a safe surgical technique, with an excellent duration and permeability and also provides a prolonged time free from cardiac events as mortality, angina, myocardial infarction, and the need of a new coronary procedure.
Bahamondes
Juan Carlos
JC
Hospital Regional de Temuco, Departamento de Cirugía, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile. jcbahamo@ufro.cl
Meriño
Gustavo
G
Silva
Abelardo
A
Salman
Juan
J
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000601:surgery*; D003327:Coronary Disease / Q000601:surgery*; D018572:Disease-Free Survival; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome