Routine use of bilateral internal mammary artery grafts for myocardial revascularization in diabetic patients: a propensity score matched study
10.7507/1007-4848.201801019
- VernacularTitle:糖尿病患者行双侧乳内动脉冠状动脉旁路移植术早期结果分析
- Author:
ZHONG Zhaoji
1
;
ZHENG Zhe
1
;
WANG Xiaoqi
1
;
GAO Ge
1
;
LI Linlin
1
;
FAN Hongguang
1
;
LI Haojie
1
Author Information
1. Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass graft;
bilateral internal mammary artery;
diabetes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(12):1038-1042
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the influence of diabetes on coronary artery bypass graft (CABG) surgery using bilateral internal mammary artery (BIMA). Methods From December 2015 to August 2017, 182 patients (153 males, 29 females, age of 56.5±6.8 years) underwent CABG using BIMA. The propensity score was used to create matched diabetes (n=66) and non-diabetes (n=66) cohorts. The operative data, post-operative outcomes and coronary computed tomographic angiography (CTA) of the diabetes group (53 males, 13 females, age of 57.8±7.2 years) and the non-diabetes group (56 males, 10 females, age of 56.3±6.0 years) were analyzed retrospectively. Results There was no peri-operative mortality. There was no difference in operative sternal wound complication (P=0.466), or graft patency (P=0.730 for internal mammary arteries and 0.684 for saphenous vein grafts) between the matched diabetes and the non-diabetes groups. However, patients with elevated glycated hemoglobin (HbA1c) (n=54) had more sternal wound complications (P=0.006). The level of Hb1Ac of the patients with sternal wound complication was significantly higher than that of the patients without sternal wound complication. Conclusion BIMA grafting may be performed routinely even in diabetic patients, without increased complications. However, elevated HbA1c level should be avoided to reduce sternal wound complication.
