Left internal mammary artery to the left anterior descending artery: effect on morbidity and mortality and reasons for nonusage

The Annals of Thoracic Surgery
S KarthikNeeraj K Mediratta

Abstract

The left internal mammary artery to the left anterior descending artery is recognized as the gold standard for revascularization. Several studies have shown the benefits of the left internal mammary artery. However, a substantial portion of patients undergoing coronary artery bypass grafting does not receive this conduit. We sought to identify reasons for nonusage of the left internal mammary artery to the left anterior descending artery, while evaluating short- and medium-term outcomes. Between April 1997 and September 2001 a total of 4406 consecutive patients underwent coronary artery bypass grafting with revascularization to the left anterior descending artery. All data were collected prospectively except reasons for nonusage of the left internal mammary artery. Logistic regression and Cox proportional hazards analyses were used to adjust in-hospital and medium-term outcomes, respectively. Selection bias was controlled by constructing a propensity score. A case note review was carried out to determine reasons for nonusage. A total of 4047 patients (91.8%) received the left internal mammary artery to the left anterior descending artery leaving 359 patients (8.2%) who did not. We found no difference in hospital mortality or mo...Continue Reading

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Citations

Jul 6, 2014·Annals of Thoracic Medicine·Efstratios ApostolakisChristos Prokakis
Feb 22, 2011·The Journal of Thoracic and Cardiovascular Surgery·Mark A HlatkyRodney H Stables
Aug 11, 2012·Asian Cardiovascular & Thoracic Annals·Saina AttaranBrian M Fabri
Mar 20, 2012·Demography·Eran ShorJoseph E Schwartz
Jul 13, 2006·Annals of the Royal College of Surgeons of England·S Karthik, B M Fabri

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