Document Detail


Bilateral internal thoracic artery surgery: 17-year experience.
MedLine Citation:
PMID:  2627966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angiographic comparisons of late morphology of internal thoracic artery (ITA) and saphenous vein grafts (SVG) in the same patients established morphologic superiority of the ITA grafts (1983). 15-year clinical follow-up of 748 consecutive patients having ITA and SVGs (532) or SVGs alone (216) established the clinical advantages given to patients by ITA grafts (1986): (1) higher cumulative survival rate (P less than 0.01); (2) less early recurrence of angina (P less than 0.01); (3) fewer late myocardial infarctions (P less than 0.02); (4) lower reoperation rate (P less than 0.001). Benefits to patients having bilateral ITA grafts (38) exceeded even those of single ITA grafts: (1) operative mortality = 0%; (2) cumulative survival (10 years) = 89.0%; (3) annual recurrence of angina = 1.5%; (4) annual late myocardial infarction = 1.1%; (5) mortality rate = 0%; (6) annual reoperation rate = 0%. These data prompted routine use of bilateral ITA grafts for all patients requiring multiple bypasses, and use of each ITA for as many bypasses as seemed feasible. Since 1986, ITA anastomoses have accounted for two thirds of anastomoses in all patients requiring multiple bypasses (average 3.2 anastomoses/patient). Results have been gratifying. Potential technical pitfalls are emphasized, and means of avoiding them described.
Authors:
G E Green; D G Swistel; A A Cameron
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  10 Suppl H     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-04-24     Completed Date:  1990-04-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  57-60     Citation Subset:  IM    
Affiliation:
Division of Cardiothoracic Surgery, St Luke's Roosevelt Hospital Center, New York, NY.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Revascularization / methods*
Postoperative Complications
Thoracic Arteries / transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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