| Internal thoracic artery vs. vein grafts--postoperative angiographic findings in symptomatic patients after 1000 days. | |
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MedLine Citation:
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PMID: 14571338 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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B Gansera; M Schiller; T Kiask; L Angelis; P Neumaier-Prauser; B M Kemkes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Thoracic and cardiovascular surgeon Volume: 51 ISSN: 0171-6425 ISO Abbreviation: Thorac Cardiovasc Surg Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-10-22 Completed Date: 2004-03-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7903387 Medline TA: Thorac Cardiovasc Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 239-43 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Klinikum Bogenhausen, Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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etiology Blood Vessel Prosthesis Coronary Angiography Coronary Artery Bypass / adverse effects*, methods Dyspnea / etiology Female Graft Occlusion, Vascular / etiology*, physiopathology, radiography* Humans Male Mammary Arteries / physiopathology, surgery* Middle Aged Saphenous Vein / physiopathology, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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