Document Detail


Right internal mammary artery for myocardial revascularization: early results and indications.
MedLine Citation:
PMID:  8512399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The right internal mammary artery (RIMA) was used for coronary artery bypass grafting in 258 patients from October 1985 to October 1991. The RIMA was inserted as the only graft in 8 patients and in combination with the left internal mammary artery (LIMA) in 231 patients, the right gastroepiploic artery in 19, and autologous vein in 184. The patients received a total of 1 to 8 distal anastomoses (mean number, 3.3). A total of 64% of the RIMAs were anastomosed to the left anterior descending coronary artery. The primary indication for use of the RIMA was small-vessel disease in 86 patients, repeat bypass grafting in 32, varicose or stripped saphenous veins in 61, and "selected routine case" in 79. The early (< or = 30 days postoperatively) mortality rate in these four groups was 8.1%, 6.3%, 0%, and 0%, respectively (p < 0.01). Independent risk factors (logistic regression analysis) for early mortality were small-vessel disease, insufficient grafting, repeat coronary artery bypass grafting, diabetes, history of smoking, age of 60 years or older, and family history of ischemic heart disease. Combined into a risk index, these risk factors identified six risk groups with early mortality of 0% in the four low-risk groups and 5.6% and 58.3% in groups V and VI, respectively (p < 0.0001). No RIMA-related variables were risk factors for significant postoperative myocardial enzyme release. Intraoperative electromagnetic flow measurements revealed no differences between the RIMA and LIMA. Early angiographic patency in 50 patients was 98% for the RIMA and 93% for the LIMA.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J Ramström; O Lund; E Cadavid; S Oxelbark; J B Thuren; A C Henze
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-13     Completed Date:  1993-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1485-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, University Hospital, Uppsala, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Coronary Circulation / physiology
Coronary Disease / epidemiology,  surgery*
Female
Graft Occlusion, Vascular / epidemiology
Hospital Mortality
Humans
Internal Mammary-Coronary Artery Anastomosis* / statistics & numerical data
Male
Middle Aged
Multivariate Analysis
Reoperation
Risk Factors
Surgical Wound Dehiscence / epidemiology
Vascular Patency / physiology

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


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