title: Medium-term survival of diffuse coronary artery disease patients following coronary artery reconstruction with the internal thoracic artery.
abstract: OBJECTIVE
  Diffuse coronary artery disease makes cardiac surgeons hesitant regarding whether coronary artery bypass grafting (CABG) surgery is feasible or not. Coronary artery reconstruction using the internal thoracic artery (ITA) allows bypassing of coronary arteries with diffuse atheromatous plaques without systematically resorting to endarterectomy. The aim of the present study was to evaluate the medium-term results of coronary artery reconstruction.
  
  
  METHODS
  All patients undergoing coronary artery reconstruction using the ITA between 1999 and 2002 (233 patients) were included in the study. The mean age was 61.9 ± 9.8 years. Two hundred and eighty-one coronary artery reconstructions using the ITA were performed (mean length 3.6 ± 2 cm) for 514 CABGs. Coronary artery reconstruction using the ITA was associated with endarterectomy in 48 cases (17%).
  
  
  RESULTS
  In-hospital mortality was 2.6%. Follow-up data were compiled in December 2008. Mean follow-up was 73.4 ± 16.7 months. The actuarial survival rate at 7 years was 89.3 ± 2.1%, and 88% of patients were free of major cardiac events at 7 years.
  
  
  CONCLUSIONS
  Coronary artery reconstruction gives comparable medium-term results to conventional coronary surgery, even though it is indicated for patients with more severe lesions.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Brest University Hospital, Brest, France.
authors.forename: Ahmed Aziz
authors.initials: AA
authors.lastname: Khalifa
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Cornily
authors.forename: Charles Henri
authors.initials: CH
authors.lastname: David
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Choplain
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.forename: Jean Aubert
authors.initials: JA
authors.lastname: Barra
authors.forename: Eric
authors.initials: E
authors.lastname: Bezon
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome