Revascularization of the right coronary artery in bilateral internal thoracic artery grafting
| Autor: | Itzhak Shapira, Rephael Mohr, Ben Gal Yanay, Ron Braunshtein, Gideon Uretzky, Nahum Nesher, Paz Yosef, Dmitry Pevni |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Reoperation medicine.medical_specialty medicine.medical_treatment Internal thoracic artery Revascularization Right gastroepiploic artery Angina medicine.artery Internal medicine medicine Myocardial Revascularization Humans Myocardial infarction Radial artery Coronary Artery Bypass Mammary Arteries Aged Aged 80 and over Aorta business.industry Middle Aged medicine.disease Surgery Survival Rate surgical procedures operative Treatment Outcome Right coronary artery Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 79(2) |
| ISSN: | 1552-6259 |
| Popis: | Background Bilateral internal thoracic artery (BITA) grafting with a composite T -graft enables right coronary artery (RCA) system revascularization with the distal end of the free right internal thoracic artery (RITA). This study compares this grafting technique to left-sided BITA grafting and RCA revascularization with the right gastroepiploic artery (RGEA) and saphenous vein grafts (SVG). Methods From April 1996 to July 1999, 1000 consecutive patients underwent left-sided revascularization with BITA. In 231 patients RCA grafting was performed with free RITA, in 246 with RGEA, in 142 with SVG, and 381 did not receive any graft to the RCA (no-graft group). Results Female gender, old age (> 70), emergency, and congestive heart failure were less prevalent in the RGEA group, and prior percutaneous transluminal coronary angioplasty was more prevalent in the no-graft group. Thirty-day mortality (3.6%, 4.9%, 2%, and 3.4% in the RITA, SVG, RGEA, and no-graft groups, respectively) and occurrence of perioperative complications (sternal infection, myocardial infarction, cerebrovascular accident, and bleeding) were similar. Overall, however, the trend was toward a higher complication rate in the RITA group (10.3%, 4.9%, 5.6%, and 7.3% respectively, p = 0.06). Midterm follow-up (40 to 78 months) showed similar 6-year survival (Kaplan-Meier) (88%, 87%, 89.5%, and 85.5%, respectively) and similar return of angina (10.8%, 6.3%, 10.6%, and 9.5%, respectively) in the four groups. Conclusions Early and midterm results in patients undergoing left-sided BITA grafting are not affected by the conduit used for RCA grafting. |
| Databáze: | OpenAIRE |
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