Revascularization with bilateral internal thoracic artery grafts in patients with left main coronary stenosis

Publisher Website
Google Scholar
Abstract
Left main occlusive disease (LMD) is a potentially fatal lesion which isoptimally treated with surgical revascularization. Although the internalthoracic artery (ITA) is recognized as having superior long term patency,there has been concern regarding possible flow limitation. Because of thisconcern, there may be reluctance to use only this conduit in patients withLMD in whom high graft flows are desirable. From 1985 to 1990, 45 patients(38 males, 7 females) with LMD ranging in age from 37 to 75 years (mean55.9 +/- 8.7) underwent revascularization using bilateral ITA grafts placedto the left anterior descending and circumflex arteries. The right ITA wasused as a free graft in 19 of 45 (42%) patients and the left ITA was usedas a free graft in 3 of 35 (7%). No saphenous vein grafts were placed tothe left coronary system in any patient. Over half of these patients (24patients, 53%) also had occlusive disease in the right coronary artery. Asaphenous vein graft was placed to the right coronary artery in 22 of 45(49%) patients. Ventricular function in this patient subset was good (meanLV score 7.1 +/- 2.1). Intra-operative ITA graft flows were 49.7 +/- 29.1ml/min for grafts to the left anterior descending and 45.5 +/- 31.7 ml/minfor circumflex grafts. There were no perioperative deaths. Morbidityincluded myocardial infarction, stroke and reoperation for bleeding in 1patient each (2.2%). Low cardiac output occurred in 2 patients (4.4%). Nopatient had a mediastinal wound infection.(ABSTRACT TRUNCATED AT 250WORDS)

This publication has 0 references indexed in Scilit: