title: Recycling of internal thoracic arteries in reoperative coronary surgery: in-hospital and midterm results.
abstract: BACKGROUND
  Selected patients, presenting for reoperative coronary surgery with patent internal thoracic arteries (ITAs), may benefit from techniques to salvage and reuse these ITA grafts. We have termed this practice the recycling of ITAs. The purpose of this study is to report our short-term and midterm results using various recycling techniques.
  
  
  METHODS
  Between April 1996 and February 2009, 60 patients underwent ITA recycling at our institution. Information regarding survival and cardiac events was obtained from a prospectively maintained, institutional database. Survival and freedom from major adverse cardiac events were calculated using Kaplan-Meier analysis. Mean follow-up duration was 60 ± 36 months.
  
  
  RESULTS
  Mean age was 64 ± 9 years and the mean time to reoperation was 117 ± 68 months. The patent ITA served as an inflow for a composite Y graft in 39 patients and was distally reimplanted on the same coronary vessel in 9 patients. A combination of these two techniques was used in 8 patients. Other techniques were used in the remaining 4 patients. Freedom from cardiac death was 93% ± 7% and 85% ± 9% at 1 and 5 years and freedom from major adverse cardiac events was 93% ± 7% and 81% ± 11% at 1 and 5 years, respectively.
  
  
  CONCLUSIONS
  Recycling of ITA grafts during reoperative coronary artery bypass grafting is safe and feasible in selected patients. These techniques can be useful in selected young patients to avoid saphenous vein graft or in patients with a lack of graft conduits.
authors: Department of Cardiovascular Medicine and Surgery, University of Louvain Medical School, Brussels, Belgium. beloumei@ulb.ac.be
authors: Bachar
authors: B
authors: El Oumeiri
authors: David
authors: D
authors: Glineur
authors: Joel
authors: J
authors: Price
authors: Munir
authors: M
authors: Boodhwani
authors: Pierre Yves
authors: PY
authors: Etienne
authors: Alain
authors: A
authors: Poncelet
authors: Laurent
authors: L
authors: De Kerchove
authors: Spiridon
authors: S
authors: Papadatos
authors: Philippe
authors: P
authors: Noirhomme
authors: Gebrine
authors: G
authors: El Khoury
mesh_terms: D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome