Total arterial revascularization with an internal thoracic artery and radial artery T graft
| Autor: | Thoralf M Sundt, Hendrick B Barner, Cynthia J Camillo, William A Gay |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Internal thoracic artery Anastomosis Postoperative Complications Thoracic Arteries medicine.artery Internal medicine medicine Humans Derivation Coronary Artery Bypass Radial artery Aged Retrospective Studies Aged 80 and over Ejection fraction medicine.diagnostic_test business.industry Anastomosis Surgical Graft Occlusion Vascular Arteries Middle Aged Surgery Outcome and Process Assessment Health Care medicine.anatomical_structure Angiography Cardiology Female Cardiology and Cardiovascular Medicine business Perfusion Follow-Up Studies Artery |
| Zdroj: | The Annals of Thoracic Surgery. 68:399-404 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(99)00563-9 |
| Popis: | 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 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: | OpenAIRE |
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