PMID: 7696787Jan 1, 1995

Arterial conduits in emergency coronary artery surgery

Journal of Cardiac Surgery
A ZapolanskiR E Shaw

Abstract

The internal thoracic artery (ITA) is considered to be the conduit of choice for coronary bypass (CABG), but there has been some reluctance to utilize the ITA for revascularization in emergency situations. In a 9-year retrospective analysis from 1986 through 1993, 484 patients had emergency CABG, 237 were not associated with failed PTCA (noninstrumented) and 247 were within 24 hours of PTCA (instrumented). About 62% of noninstrumented and 49.3% of instrumented patients received one or more ITA grafts, the others receiving only saphenous vein grafts (SVGs). Those who received an ITA graft tended toward male sex, better ejection fraction, and a generally lower clinical risk score. Instrumented patients tended toward a lower incidence of diabetes and left main coronary disease, higher ejection fraction, and lower clinical risk score than noninstrumented patients. The postoperative results were not significantly different between ITA and SVG groups with respect to new Q waves, need for reexploration, sternal wound infection, respiratory complications, or stroke. However, ITA patients more often had an event-free postoperative course, received fewer blood transfusions, and experienced fewer cardiac deaths (2.7% vs 9.4%, p < 0.01). T...Continue Reading

References

May 1, 1991·Catheterization and Cardiovascular Diagnosis·R K MylerA Zapolanski
Feb 11, 1991·The Annals of Thoracic Surgery·M A GreeneC Mavroudis
Jun 1, 1989·The Annals of Thoracic Surgery·K S NaunheimM Vandormael
Feb 1, 1989·Circulation·R A Bruce
Aug 1, 1985·The Annals of Thoracic Surgery·D A KillenW A Reed
Jan 2, 1986·The New England Journal of Medicine·F D LoopW C Sheldon
Jan 1, 1994·The Annals of Thoracic Surgery·F H EdwardsM Schwartz
Jan 1, 1994·The Annals of Thoracic Surgery·F H EdwardsM Schwartz

Citations

Apr 8, 1998·Journal of the American College of Cardiology·R G Favaloro
Jul 4, 2006·Critical Care : the Official Journal of the Critical Care Forum·Bonizella BiagioliPaolo Barbini
Oct 31, 2019·International Journal of Psychiatry in Clinical Practice·Mehmet KaradagAyse Sevde Sarp

Related Concepts

Coronary Artery Bypass Surgery
Emergencies [Disease/Finding]
Postoperative Complications
Retrospective Studies
Percutaneous Transluminal Coronary Angioplasty

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