Document Detail

Off-pump coronary artery bypass grafting with skeletonized bilateral internal thoracic arteries in insulin-dependent diabetics.
MedLine Citation:
PMID:  17588377     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We evaluated the effects of coronary artery bypass with off-pump skeletonized bilateral internal thoracic artery grafting in patients with insulin-dependent diabetes. METHODS: One hundred eighty-five consecutive patients with insulin-dependent diabetes who underwent isolated coronary artery bypass grafting with bilateral internal thoracic grafts were retrospectively compared according to surgical technique, ie, off-pump grafting with skeletonized internal thoracic artery (n = 162) or on-pump grafting with pedicled internal thoracic artery (n = 23). RESULTS: The on-pump group was younger (62.3 +/- 9.2 versus 69.9 +/- 8.5 years; p = 0.02) and had fewer distal anastomoses (3.5 +/- 1.0 versus 4.0 +/- 1.1; p = 0.02) than the off-pump group. No 30-day mortality occurred in either group. The incidence of deep sternal infection was significantly lower in the off-pump group than in the on-pump group (0.6% versus 13.0%; p = 0.01). The early angiographic results did not differ between the two groups. The median duration of follow-up was 3.4 years (range, 0.1 to 9.9 years). Rates of survival, freedom from cardiac mortality, and freedom from cardiac-related events (including cardiac-related death, myocardial infarction, percutaneous coronary intervention, repeat coronary artery bypass grafting, and congestive heart failure) did not differ between the two groups. Dialysis, peripheral vascular disease, ejection fraction less than 0.40, and age were independent risk factors of late death. CONCLUSIONS: Overall, our results support the surgical management of coronary artery bypass grafting in insulin-dependent diabetics using off-pump skeletonized bilateral internal thoracic artery grafting.
Masashi Kai; Michiya Hanyu; Yoshiharu Soga; Takuya Nomoto; Jota Nakano; Takehiko Matsuo; Eitaro Umehara; Masahide Kawato; Hitoshi Okabayashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  84     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  32-6     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Kokura Memorial Hospital, Fukuoka, Japan.
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MeSH Terms
Coronary Angiography
Coronary Artery Bypass, Off-Pump / methods*,  mortality
Diabetes Mellitus, Type 1 / complications*
Internal Mammary-Coronary Artery Anastomosis / methods*
Middle Aged
Proportional Hazards Models
Retrospective Studies
Comment In:
Ann Thorac Surg. 2007 Jul;84(1):36-7   [PMID:  17588378 ]

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