Document Detail

Conduits for coronary bypass: internal thoracic artery.
MedLine Citation:
PMID:  23275918     Owner:  NLM     Status:  PubMed-not-MEDLINE    
This second report in the series on coronary artery bypass presents the authors experience and personal views on the internal thoracic artery (ITA) which date to 1966. There has been a very gradual evolution in the acceptance of this conduit which was initially compared with the saphenous vein and viewed as an improbable alternative to it. As is common with concepts and techniques which are 'outside the box' there was skepticism and criticism of this new conduit which was more difficult and time consuming to harvest for the surgeon who had to do it all. It was viewed as small, fragile, spastic and its flow capacity was questioned. Only a few surgeons employed it because of these issues and some of them would frequently graft it to the diagonal artery as it was thought not to supply adequate flow for the left anterior descending unless it was small. After a decade, angiographic data revealed superior patency to vein grafts. Even this evidence and survival benefit reported a few years later did not convince many surgeons that their concerns about limitations justified its use. Thus widespread adaption of the ITA as the conduit of choice for the anterior descending required another decade and bilateral use is only now expanding to more than 5% of patients in the US and somewhat faster in other countries.
Hendrick B Barner
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Publication Detail:
Type:  Journal Article     Date:  2012-12-07
Journal Detail:
Title:  The Korean journal of thoracic and cardiovascular surgery     Volume:  45     ISSN:  2233-601X     ISO Abbreviation:  Korean J Thorac Cardiovasc Surg     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-01-01     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101563922     Medline TA:  Korean J Thorac Cardiovasc Surg     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  351-67     Citation Subset:  -    
Division of Cardiothoracic Surgery, St. Louis University Hospital, USA.
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