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[Myocardial revascularization with arterial grafts alone: our experience].
- Source :
-
Giornale italiano di cardiologia [G Ital Cardiol] 1991 Oct; Vol. 21 (10), pp. 1057-63. - Publication Year :
- 1991
-
Abstract
- Bilateral internal mammary artery (IMA) grafting is recognized as a preferred method of myocardial revascularization. However, for multivessel coronary artery disease, saphenous veins often have to be added to complete myocardial revascularization. The right gastroepiploic artery (rGEA) has been recently recognized as a suitable arterial conduit to obtain with both IMAs a complete myocardial revascularization without conventional vein graft. From December 1985 to July 1990, 87 selected patients underwent coronary artery bypass grafting using only the two IMAs and, from December 1988, the rGEA. There were a total of 220 coronary artery bypass grafts (mean 3.06/patient) and 267 coronary artery anastomoses (mean 1.21 anastomoses graft). There was one perioperative death (1.14%), 3 patients (3.5%) developed a perioperative myocardial infarction, and 7 patients (8.04%) needed a transitory inotropic pharmacological support. Two patients (2.29%) underwent reoperation for bleeding, and a third (1.14%) for sternal diastase. Fifty-five patients (63.2%) underwent postoperative angiography: 6/139 grafts (4.31%) (3 rGEA free, 2 rIMA free, 1 rIMA in situ) were occluded. After follow-up, ranging from 12 to 66 months (30.54 average), 77 patients (92.77%) were free from angina, one patient underwent reoperation 7 months later and a third died for sudden death 55 months after the operation. There were no gastric complications due to rGEA harvesting. Actually, bilateral IMA grafting is the best investment for the patient who needs myocardial revascularization. The rGEA is a promising conduit whose only concern could be the long-term patency; this will be resolved in the future. Up-to-date combined arterial graft utilizing the IMA and the rGEA can facilitate complete revascularization by arterial grafts safely and effectively.
- Subjects :
- Coronary Artery Bypass methods
Coronary Artery Bypass mortality
Coronary Artery Bypass statistics & numerical data
Humans
Internal Mammary-Coronary Artery Anastomosis methods
Internal Mammary-Coronary Artery Anastomosis mortality
Internal Mammary-Coronary Artery Anastomosis statistics & numerical data
Myocardial Infarction mortality
Myocardial Infarction surgery
Myocardial Revascularization mortality
Myocardial Revascularization statistics & numerical data
Postoperative Complications epidemiology
Postoperative Complications mortality
Postoperative Complications surgery
Reoperation statistics & numerical data
Myocardial Revascularization methods
Subjects
Details
- Language :
- Italian
- ISSN :
- 0046-5968
- Volume :
- 21
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Giornale italiano di cardiologia
- Publication Type :
- Academic Journal
- Accession number :
- 1687137