Internal mammary artery versus saphenous vein graft to the left anterior descending coronary artery: prospective randomized study with 10-year follow-up
| Autor: | Chamnahn Kongtahworn, James R. Skinner, Mark Spector, David F. Gordon, Steven J. Phillips, Robert H. Zeff, L.A. Iannone, T.M. Brown |
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| Rok vydání: | 1988 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Time Factors Heart Diseases medicine.medical_treatment Anterior Descending Coronary Artery Revascularization Surgical anastomosis Random Allocation Thoracic Arteries Internal medicine medicine Vascular Patency Humans Saphenous Vein Myocardial infarction Derivation Prospective Studies Coronary Artery Bypass Mammary Arteries Prospective cohort study business.industry Middle Aged medicine.disease Surgery Stenosis Heart Function Tests Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of thoracic surgery. 45(5) |
| ISSN: | 0003-4975 |
| Popis: | In 1975, 80 patients undergoing revascularization were prospectively randomized to receive either a greater saphenous vein (SV) graft (41 patients, Group 1) or a left internal mammary artery (LIMA) graft (39 patients, Group 2) to the left anterior descending coronary artery (LAD). All patients were completely revascularized. The average number of grafts per patient in both groups was 3.2. Patients were followed 10 years; follow-up was 97.5% complete. Group 1 and Group 2 were compared in regard to mortality, treadmill response, myocardial infarction, reoperation, percutaneous transluminal coronary angioplasty, and return to work. Mortality in Group 1 was 17.9% versus 7.7% in Group 2 (p less than 0.05). Treadmill studies were positive in 17 Group 1 patients and 7 Group 2 patients (p less than 0.05). Myocardial infarctions occurred in 8 patients in Group 1 versus 3 in Group 2. The number of reoperations was 2 in Group 1 versus 1 in Group 2. Percutaneous transluminal coronary angioplasty was performed in 3 patients in Group 1 and 2 in Group 2. Repeat studies revealed 76.3% patency of the SV graft to the LAD (Group 1) and 94.6% patency of the LIMA graft to the LAD (Group 2). Cardiac-related mortality in Group 1 was 12.8% at 10 years (5 patients) versus 7.7% in Group 2 (3 patients). Based on this study, the IMA is a superior conduit for bypass to the LAD. |
| Databáze: | OpenAIRE |
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