Limits of arterial myocardial revascularization

Journal of Cardiac Surgery
O JegadenP Mikaeloff

Abstract

A prospective study of myocardial blood perfusion after coronary artery bypass graft (CABG) was conducted in two groups of patients. In group 1, a two-year assessment by exercise thallium myocardial scintigraphy without medical treatment was performed in 122 patients who consecutively underwent CABG with exclusive use of both internal mammary arteries (IMA) and gastroepiploic artery (GEA). In group 2, myocardial function and perfusion were determined by radionuclide investigations performed before and one year after CABG in 100 patients with preoperative LV dysfunction (defined as LV ejection fraction (LVEF) less than 0.40), comparing results of myocardial revascularization performed with either exclusive arterial grafts (arterial group, 54 patients) or one arterial graft (IMA) associated with a sequential vein graft (vein group, 46 patients). In group 1, 21% of patients presented silent residual electric ischemia during exercise stress testing and 26% had reversible scintigraphic ischemic defect despite complete revascularization, 18% of those in the inferior wall bypassed with GEA and 8% in the anterior wall bypassed with the right IMA. In group 2, the significant preoperative ischemia significantly decreased in both the vein...Continue Reading

References

Nov 1, 1993·The Annals of Thoracic Surgery·G M PalatianosG A Kaiser
Oct 1, 1993·The Annals of Thoracic Surgery·M KawasujiY Watanabe
May 1, 1996·The Annals of Thoracic Surgery·R K ChanB F Buxton
Dec 1, 1996·Circulation·R O Bonow
Apr 30, 1999·The Journal of Thoracic and Cardiovascular Surgery·B W LytleD M Cosgrove
Jan 5, 2000·The Annals of Thoracic Surgery·J TatoulisA G Royse

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