title: Off-pump bilateral internal thoracic artery grafting in patients with left main disease.
abstract: OBJECTIVE
  This study assessed the safety and efficacy of off-pump bilateral internal thoracic artery grafting in patients with left main disease.
  
  
  METHODS
  We reviewed the records of 768 patients who underwent off-pump bilateral internal thoracic artery grafting between September 2004 and June 2009. Bilateral internal thoracic artery grafts were used for the left coronary system in all patients, of whom 268 had left main disease and 500 did not. We compared operative and postoperative variables and early and 1-year angiographic patency rates of the bilateral internal thoracic artery between the 2 groups.
  
  
  RESULTS
  The perioperative mortality and incidence of postoperative complications were not significantly different between groups. In patients without left main disease, the left and right internal thoracic arteries were used for the left anterior descending artery in 87.4% and 12.2% of patients, respectively. In patients with left main disease, the left and right internal thoracic arteries were used for the left anterior descending artery in 70.5% and 29.1% of patients, respectively. In patients with left main disease, the patency rates for the left and right internal thoracic arteries at 1-year postoperative follow-up were 97.0% and 93.2%, respectively. In patients without left main disease, the patency rates for the left and right internal thoracic arteries at 1-year follow-up were 97.6% and 91.6%, respectively. The patency rates of the left and right internal thoracic arteries did not differ significantly in patients with or without left main disease (P = .9803 and P = .7205 in left and right internal thoracic arteries, respectively).
  
  
  CONCLUSIONS
  Off-pump bilateral internal thoracic artery grafting was safe and effective in patients with left main disease. The patency rates of both grafts were comparable to those of patients without left main disease.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Fuchu City, Tokyo, Japan. tfukui-cvs@umin.ac.jp
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Minoru
authors.initials: M
authors.lastname: Tabata
authors.forename: Susumu
authors.initials: S
authors.lastname: Manabe
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shimokawa
authors.forename: Jun
authors.initials: J
authors.lastname: Shimizu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects / Q000401:mortality; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency