Total arterial revascularization with an internal thoracic artery and radial artery T graft.

Autor:	Sundt TM 3rd; Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. sundtt@msnotes.wustl.edu, Barner HB, Camillo CJ, Gay WA Jr
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 1999 Aug; Vol. 68 (2), pp. 399-404; discussion 404-5.
DOI:	10.1016/s0003-4975(99)00563-9
Abstrakt:	Background: Proximal anastomosis of the radial artery to the side of the internal thoracic artery (ITA) permits complete arterial revascularization in most patients, with the aim of improving long-term results of coronary artery bypass through greater long-term graft patency. The short-term results, however, have yet to be defined. We therefore reviewed our early experience with this grafting strategy. Methods: Between October 1, 1993, and September 1, 1998, 649 patients aged 30 to 85 years (mean, 60+/-10 years) had primary coronary artery bypass using an ITA and radial artery in a T-graft configuration. Left ventricular function was severely depressed (ejection fraction <35%) in 12%, and left main stenosis was present in 14%. Results: A total of 937 distal anastomoses were performed with the left ITA (1.4 per patient) and 1,452 with the radial artery (2.2 per patient). There was one perioperative death (0.2%). There were 32 (5%) q-wave myocardial infarctions, and 14 patients (2%) had transient low output syndrome. There was one episode of hypoperfusion corrected by lengthening the left ITA. Angiography for clinical indications in 27 patients 1 to 35 months postoperatively (mean, 9.5+/-8.3 months) demonstrated a distal anastomotic patency of 100% for ITA and 82% for radial artery grafts. Conclusions: Complete arterial revascularization can be achieved with an ITA and radial artery T-graft with low operative risk and acceptable early patency. These results support the continued investigation of this grafting strategy.
Databáze:	MEDLINE
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