title: Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation.
abstract: OBJECTIVE
  To assess the patency of the pedicled right internal thoracic artery with an anteroaortic course and compare it to the patency of the left internal thoracic artery , in anastomosis to the left anterior descending artery in coronary artery bypass grafting by using coronary CT angiography at 6 months postoperatively.
  
  
  METHODS
  Between December 2008 and December 2011, 100 patients were selected to undergo a prospective coronary artery bypass grafting procedure without cardiopulmonary bypass. The patients were randomly divided by a computer-generated list into Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used was known at the beginning of the surgery. In G-1, coronary artery bypass grafting was performed using the left internal thoracic artery for the left anterior descending and the free right internal thoracic artery for the circumflex, and in G-2, coronary artery bypass grafting was performed using the right internal thoracic artery pedicled to the left anterior descending and the left internal thoracic artery pedicled to the circumflex territory.
  
  
  RESULTS
  The groups were similar with regard to the preoperative clinical data. A male predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five patients migrated from G-1 to G-2 because of atheromatous disease in the ascending aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20 (SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that all ITAs, right or left, used in situ for the left anterior descending were patent. There were no deaths in either group.
  
  
  CONCLUSIONS
  Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic right internal thoracic artery to the left anterior descending artery has an outcome similar to that obtained using the left internal thoracic artery for the same coronary site.
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Maurilio Onofre
authors.initials: MO
authors.lastname: Deininger
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luiz Felipe Pinho
authors.initials: LF
authors.lastname: Moreira
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luiz Alberto Oliveira
authors.initials: LA
authors.lastname: Dallan
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Orlando Gomes de
authors.initials: OG
authors.lastname: Oliveira
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Daniel Marcelo Silva
authors.initials: DM
authors.lastname: Magalhães
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: José Reinaldo de Moura
authors.initials: JR
authors.lastname: Coelho
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Eugênia di Giuseppe
authors.initials: Ed
authors.lastname: Deininger
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Norland de Souza
authors.initials: Nde S
authors.lastname: Lopes
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Ricardo Wanderley
authors.initials: RW
authors.lastname: Queiroga
authors.affiliation: Hospital Unimed João Pessoa, João Pessoa, PB, Brasil.
authors.forename: Elizabeth Ferreira
authors.initials: EF
authors.lastname: Belmont
mesh_terms: D000714:Anastomosis, Surgical; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008488:Medical Illustration; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*