Coronary Artery Bypass Grafting Using in Situ Bilateral Internal Thoracic Arteries
10.4326/jjcvs.34.176
- VernacularTitle:Ｉｎ ｓｉｔｕ ａｌｌ ａｒｔｅｒｉａｌ ＯＰＣＡＢを目指した両側内胸動脈使用法の検討
- Author:
Tomoaki Suzuki
;
Manabu Okabe
;
Fuyuhiko Yasuda
;
Yoichiro Miyake
;
Satofumi Tanaka
- Publication Type:Journal Article
- Keywords:
off-pump coronary artery bypass grafting (OPCAB);
in situ graft
- From:Japanese Journal of Cardiovascular Surgery
2005;34(3):176-179
- CountryJapan
- Language:Japanese
-
Abstract:
Coronary artery bypass grafting (CABG) using in situ skeletonized arterial conduits with an off-pump technique is a high quality and minimally invasive procedure. The internal thoracic artery (ITA) is the most reliable conduit as grafting the left anterior descending artery and circumflex arteries with bilateral ITAs leads to better long-term patient outcomes. In this study, we demonstrated the feasibility and usefulness of off-pump coronary artery bypass grafting surgery using bilateral ITAs. A total of 217 consecutive CABG cases using skeletonized ITA grafts were studied and they were divided into 2 groups are using unilateral ITA (UITA, n=104) and the other using bilateral ITA (BITA, n=113). OPCAB was completed in 94% (98/104) in the UITA group and in 99% (112/113) in the BITA group. The mean number of distal anastomoses per patient was 3.02 in the UITA group and 3.63 in the BITA group. The ITAs were used in situ in 100% (104 ITAs) in the UITA group and in 96% (217 ITAs) in the BITA group. One patient in the UITA group suffered from mediastinitis and one patient in the BITA group died due to intestinal ischemia 3 days after operation. Postoperative angiography was performed before discharge in 101 patients in UITA and 99 in BITA. The patency rate was 98.7% in the UITA group and 99.4% in the BITA group. OPCAB with bilateral skeltonized ITAs is a feasible and safe technique with excellent early clinical results and graft patency. OPCAB using in situ skeletonized artery conduits can become a standard surgical treatment for ischemic heart disease.
