PMID: 8442986Jan 1, 1993Paper

Total arterial myocardial revascularization

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Giovanni PaoliniA Grossi

Abstract

The superiority of the internal thoracic artery (ITA) compared with venous conduits in terms of late graft patency is nowadays well documented. The inferior epigastric artery (IEA) was recently proposed as an alternative conduit for coronary artery surgery with good early clinical and angiographic results. To improve the benefits from myocardial revascularization, we expanded the use of these arterial conduits. From June 1988 to December 1991, 615 patients underwent coronary surgery in our institute. In 138 of them (22.4%) we performed total arterial myocardial revascularization placing 2 or more coronary anastomoses. An average of 2.37 anastomoses per patient were placed with the maximum number of 6 in one case. Only one patient died of cardiac related causes (0.72%). Perioperative morbidity included myocardial infarction and sternal dehiscence in 5 patients each (3.6%). No stroke or reoperation for bleeding occurred. No rectus muscle necrosis was recorded. Accurate preoperative planning of graft placement allows for the performance of as many as 6 distal anastomoses using bilateral ITA and single IEA grafts only, thus completely revascularizing most of the hearts with three-vessel disease. In our series this procedure was not...Continue Reading

Citations

May 29, 1997·The New England Journal of Medicine·N T KouchoukosV G Davila-Roman
Sep 20, 2008·Interactive Cardiovascular and Thoracic Surgery·Theo Kofidis, Felix Woitek

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