Early Results of Coronary Artery Bypass Graft with Purely Bilateral Internal Thoracic Arteries Using Y-anastomosis in Multiple Coronary Artery Disease Patients: Coronary Angiographic Analysis.
- Author:
Kiick SUNG
1
;
Young Tak LEE
;
Kay Hyun PARK
;
Tae Gook JUN
;
Pyo Won PARK
;
Il Yong HAN
;
Yunhee CHANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery of Samsung Medical Center, Sungkwunkwan University School of Medicine, Korea. wizski@hanmail.net
- Publication Type:Original Article
- Keywords:
Coronary artery bypass;
Internal thoracic artery;
Vascular patency
- MeSH:
Angiography;
Aortic Valve;
Cardiac Output, Low;
Coronary Angiography;
Coronary Artery Bypass*;
Coronary Artery Disease*;
Coronary Stenosis;
Coronary Vessels*;
Emergencies;
Heart Arrest;
Hemorrhage;
Humans;
Infarction;
Ischemic Attack, Transient;
Length of Stay;
Male;
Mammary Arteries*;
Postoperative Complications;
Reoperation;
Retrospective Studies;
Risk Factors;
Transplants;
Vascular Patency;
Wound Infection
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(3):142-149
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. MATERIAL AND METHOD: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively. The mean age of these patients was 61.2+/-8.5 (range: 30~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. RESULT: The mean number of distal anastomoses was 3.1+/-0.9 (range: 2~6), the mean duration of hospital stay was 8.4+/-4.5 days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean 4.1+/-0.8/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. CONCLUSION: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.
