title: Pedicled right internal mammary artery for reoperative off-pump revascularization of left anterior descending coronary artery.
abstract: In situ right internal mammary artery is the graft of choice in reoperative off-pump coronary artery bypass grafting, as well as in primary on-pump coronary artery bypass grafting, unless the vessel has been used previously. However, there are not enough data about postoperative angiographic findings of the in situ right internal mammary artery in reoperative coronary artery bypass grafting with the off-pump technique. From September 1993 through January 2004, we reviewed the postoperative course and the graft patency of 12 selected patients who underwent off-pump coronary artery bypass grafting reoperation only for revascularization of the left anterior descending artery, by means of a pedicled right internal mammary artery graft. All patients were evaluated clinically and by postoperative coronary angiography. There were no early or late deaths during the mean follow-up period of 33.08 +/- 30.05 months (range, 1-77 months). The mean interval from the 1st operation to the 2nd operation was 74.1 +/- 57.01 months (range, 4.5-171 months). Postoperative coronary angiograms of all patients showed a 100% patency rate for both in situ grafts and composite grafts. We suggest that use of the in situ right internal mammary artery in off-pump coronary artery bypass grafting is a safe and reliable option for revascularizing the left anterior descending artery, especially in reoperation.
authors.affiliation: Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, 34718 Istanbul, Turkey. erenerus@yahoo.com
authors.forename: Ercan
authors.initials: E
authors.lastname: Eren
authors.forename: Mehmet
authors.initials: M
authors.lastname: Balkanay
authors.forename: Mehmet Erdem
authors.initials: ME
authors.lastname: Toker
authors.forename: Berk
authors.initials: B
authors.lastname: Ozkaynak
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Keles
authors.forename: Mustafa
authors.initials: M
authors.lastname: Guler
authors.forename: Cevat
authors.initials: C
authors.lastname: Yakut
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013536:Suture Techniques; D014654:Vascular Patency