Multivessel Coronary Revascularization with Composite LITA-RA Y Graft.
- Author:
Sub LEE
1
;
Oh Choon KWON
;
Moo Sung KO
;
Ki Sung PARK
;
Jae Kean RYU
;
Jae Suk JANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, School of Medicine, Catholic University of Daegu, Korea. ockwon@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Graft;
Coronary artery bypass;
Internal thoracic artery;
Radial artery
- MeSH:
Arteries;
Coronary Angiography;
Coronary Artery Bypass;
Coronary Artery Bypass, Off-Pump;
Coronary Vessels;
Emergencies;
Female;
Heart Ventricles;
Humans;
Hyperlipidemias;
Hypertension;
Length of Stay;
Mammary Arteries;
Pulmonary Disease, Chronic Obstructive;
Radial Artery;
Risk Factors;
Shock, Cardiogenic;
Transplants*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2006;39(5):359-365
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. MATERIAL AND METHOD: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was 62.6+/-8.8 years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%. There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. RESULT: The number of distal anastomoses was 3.1+/-0.91 and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%,and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). CONCLUSION: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.
