| Sequential internal mammary artery grafts. Expanded utilization of an ideal conduit. | |
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MedLine Citation:
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PMID: 2982065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The internal mammary artery, when used as a conduit for coronary artery bypass, offers a better long-term patency rate and survival rate than the saphenous vein; however, its utility has been limited. Among other factors, the availability of only two internal mammary arteries for anastomosis has been a major limitation. In an attempt to overcome this limitation, we constructed sequential internal mammary artery grafts in 87 patients. In 49 patients (Group I), only one internal mammary artery was used for sequential anastomosis. In another 31 patients (Group II), one internal mammary artery was used for sequential anastomosis and the other was used for single end-to-side anastomosis. Both internal mammary arteries were used in seven patients (Group III) for the construction of sequential anastomoses. Postoperatively, 64 patients were evaluated by exercise stress tests. None of these patients had a positive stress test although seven patients (11%) had electrocardiographic changes that were considered equivocal. Coronary angiography was performed in 35 of the 87 patients, with 92 vein grafts and 90 internal mammary artery anastomotic sites evaluated within 1 year of operation. A total of 83 vein grafts and 84 internal mammary artery anastomotic sites evaluated within 1 year of operation. A total of 83 vein grafts and 84 internal mammary artery anastomoses were found to be patent. Thus the patency rate for vein grafts was 90% and for internal mammary artery grafts, 93%. During the follow-up period (8 to 52 months), three patients died and one was lost to follow-up. Among the remaining patients, 79 had complete relief from symptoms, three had minimal symptoms, and one patient obtained no relief from symptoms. Based on these results, we have concluded that the extended use of internal mammary artery, constructing sequential anastomoses, is technically feasible and provides adequate perfusion to the area of myocardium supplied by such grafts. |
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Authors:
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M L Kamath; L S Matysik; D H Schmidt; L L Smith |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 89 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1985 Feb |
Date Detail:
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Created Date: 1985-03-12 Completed Date: 1985-03-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 163-9 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Coronary Angiography Coronary Artery Bypass Coronary Disease / radiography, radionuclide imaging, surgery* Diphosphates / diagnostic use Exercise Test Female Graft Occlusion, Vascular Humans Internal Mammary-Coronary Artery Anastomosis / methods* Male Middle Aged Myocardial Infarction / etiology Myocardial Revascularization / methods* Postoperative Complications Saphenous Vein / transplantation Technetium / diagnostic use Technetium Tc 99m Pyrophosphate |
| Chemical | |
Reg. No./Substance:
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0/Diphosphates; 0/Technetium Tc 99m Pyrophosphate; 7440-26-8/Technetium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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