Document Detail


Sequential mammary grafting. Clinical, functional, and angiographic assessment 6 months postoperatively in 231 consecutive patients.
MedLine Citation:
PMID:  2739428     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between September 1985 and November 1987, 246 sequential mammary grafts were performed in 231 consecutive patients. Seventy-eight percent had triple vessel disease, and 33% required an urgent procedure. The length of the internal mammary artery pedicle was the only limitation to its use. No account was taken of the free cut-end flow of the internal mammary artery. There were 14 bilateral sequential mammary grafts and 15 free sequential mammary grafts. Of the 531 sequential mammary anastomoses, 482 were built with the left internal mammary artery; 113 (21%) were diamond-shaped anastomoses. The right internal mammary artery was brought through the transverse sinus in 44 cases, 10 times for sequential grafting of circumflex branches. Taking into account the adjunctive venous anastomoses and the single internal mammary artery anastomoses, there were 4.5 distal anastomoses per patient, 2.8 being mammary anastomoses and 2.3 being sequential mammary anastomoses. The hospital mortality rate was 2.6%. The prevalence of perioperative myocardial infarction was 5.2%. Follow-up was complete and averaged 15.4 months. Six patients (2.7%) still had angina pectoris. One hundred fifty-seven (71%) patients were recatheterized 6 months after the operation, and 95% of the sequential mammary anastomoses were still patent. The patency rate of the diamond-shaped mammary anastomoses was 94.5% and that of the anastomoses corresponding to the right internal mammary arteries brought through the transverse sinus was 94.3%. The gratifying functional results (maximal stress test combined with exercise thallium scintigraphy) obtained at an average of 6 months postoperatively illustrated the surprising physiologic adaptability of the internal mammary artery. As the attrition rate of the mammary artery grafts beyond 6 months postoperatively is thought to be minimal, gratifying long-term results with widespread use of sequential mammary grafts can be anticipated.
Authors:
R Dion; R Verhelst; M Rousseau; M Goenen; R Ponlot; Y Kestens-Servaye; C H Chalant
Related Documents :
2375548 - Bilateral mammary artery bypass and sternal dehiscence. a favorable outcome.
3241318 - Coronary artery bypass grafting by utilizing the internal mammary artery graft in 100 j...
3291198 - Significance of early angiographic follow-up after internal thoracic artery anastomosis...
8049988 - Tricuspid valve myxoma in a child with coronary artery occlusion and aneurysms.
22749018 - Interstitial trophoblast cells: an enigmatic and variable component of the developing m...
23731298 - Antegrade in situ stent-graft fenestration for the renal artery following inadvertent c...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  98     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-08-10     Completed Date:  1989-08-10     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:  80-8; discussion 88-9     Citation Subset:  AIM; IM    
Affiliation:
Université Catholique de Louvain, Brussels, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / etiology
Coronary Disease / mortality,  physiopathology,  surgery*
Dyspnea / etiology
Electrocardiography
Exercise Test
Female
Follow-Up Studies
Humans
Internal Mammary-Coronary Artery Anastomosis / methods*
Male
Mammary Arteries / radiography,  transplantation*
Middle Aged
Postoperative Complications
Reoperation
Thoracic Arteries / transplantation*
Time Factors
Vascular Patency

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


Previous Document:  Direct surgical treatment of atrioventricular node reentrant tachycardia.
Next Document:  Intraoperative prebypass and postbypass epicardial color flow imaging in the repair of atrioventricu...