Document Detail


Sequential internal mammary artery grafts. Expanded utilization of an ideal conduit.
MedLine Citation:
PMID:  2982065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M L Kamath; L S Matysik; D H Schmidt; L L Smith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  1985-03-12     Completed Date:  1985-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
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:
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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