Document Detail

Internal thoracic artery vs. vein grafts--postoperative angiographic findings in symptomatic patients after 1000 days.
MedLine Citation:
PMID:  14571338     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Superior patency-rate of ITA, especially BITA-grafting to saphenous vein grafts, is conclusive. This study evaluates angiographic findings postoperatively in 663 symptomatic patients receiving one or both ITAs and vein grafts. METHODS: 663 patients (553 male, mean age 62) with CABG operated between 1/94 and 6/02 underwent reangiography due to reappearance of angina or unclear cardiac symptoms. Angiographic data were compared for patency rate of single ITA (n = 379), bilateral ITA (n = 220) or vein grafts. Recatherization was performed after an average of 1000 days (+/- 766 days). Severe bypass stenosis or occlusion was related to target vessels for all grafts. RESULTS: 2099 Bypasses were performed in 663 patients. Severe stenosis or occlusion was detected in 255 ACB (19.9 %) of 1280 and 93 ITAs of 819 (11.4 %, p < 0.001). Patency was 88.8 % (532) for LITA, 88.2 % (194) for RITA. Target vessels were as follows: LITA: 60 % (358) LAD, 23.5 % (141) CX, RITA: 82 % (180) LAD. Occlusion rate for LITA was as follows: to LAD 7 %, to DIA 8.7 %, to CX 8.5 %. Occlusion rate for RITA as follows: to LAD 6.7 %, to DIA 16.7 %, to CX 0, to RCA 14.3 %. Occlusion rate for ACB was as follows: to LAD 18.7 %, to DIA 12.6 %, to CX 14.1 %, to RCA 16.1 %. Despite symptoms, bypass patency was observed in 412 (62.1 %) of 663 patients. CONCLUSIONS: Superior patency of ITA, especially BITA grafting could be documented angiographically in a negative selected symptomatic population. Graft occlusion was nearly two fold higher in vein grafts. Our surgical strategy, revascularizising RITA with LAD, LITA with circumflex artery results in satisfactory mid-term graft patency.
B Gansera; M Schiller; T Kiask; L Angelis; P Neumaier-Prauser; B M Kemkes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  51     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-22     Completed Date:  2004-03-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  239-43     Citation Subset:  IM    
Department of Cardiovascular Surgery, Klinikum Bogenhausen, Munich, Germany.
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MeSH Terms
Angina Pectoris / etiology
Blood Vessel Prosthesis
Coronary Angiography
Coronary Artery Bypass / adverse effects*,  methods
Dyspnea / etiology
Graft Occlusion, Vascular / etiology*,  physiopathology,  radiography*
Mammary Arteries / physiopathology,  surgery*
Middle Aged
Saphenous Vein / physiopathology,  surgery*

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