Document Detail


The descending branch of lateral femoral circumflex artery in arterial CABG: early and midterm results.
MedLine Citation:
PMID:  12822625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Different arterial conduits have been used for coronary artery bypass grafting (CABG), avoiding remote cardiac events associated with graft failure and improving the quality and expectancy of life in patients with coronary artery disease. The goal of this study was to evaluate the early and midterm results of total arterial CABG with the descending branch of the lateral femoral circumflex artery (DLFCA). METHODS: Between February 1997 and December 2001, 147 patients underwent arterial CABG using the DLFCA at our department. The patients were followed to determine perioperative cardiac events. Angiographic follow-up controls were performed at the end of surgery in 81 patients (55.1%), within 1 year in 82 patients (55.7%), and within 3 years in 48 patients (32.6%). The actuarial survival and event-free rates, the occurrence of late cardiac events and death, the cumulative rate of the DLFCA graft patency, and the incidence of spasm were investigated. RESULTS: The DLFCA was used in all patients (113 men and 34 women, with a mean age of 56 +/- 12.6 years). The proximal anastomoses of the DLFCA was performed with the left internal mammary artery (LIMA) in 95% and with the right internal mammary artery (RIMA) in 5% of patients. The distal anastomoses of the DLFCA was performed with the left anterior descending (LAD) coronary artery in 3.5%, with the diagonal artery in 17%, with the intermedius ramus in 7.5%, with the posterior interventricular artery in 2%, and with the branch of circumflex artery in 70% of patients. The in-hospital mortality and morbidity rates were 0% and 7.4%, respectively. Complications related to DLFCA harvesting was transient dysesthesia of the thigh, observed in 6 patients (4%). No postoperative myocardial infarction attributable to DLFCA bypass was observed. During the late follow-up period of 22.09 +/- 16.8 months, cardiac events were observed in 14 patients (9.5%), including recurrence of angina in 6, arrhythmia requiring hospitalization in 4, congestive heart failure in 2, percutaneous transluminal angioplasty in 1, and sudden death in 1 patient. Actuarial 1- and 3-year survival rates after surgery were 100% and 99.3%, respectively. Actuarial 1- and 3-year event-free rates were 97.3% and 90.5%, respectively. Actuarial 1- and 3-year patency rates were 97.5% and 93.7%, respectively. CONCLUSIONS: No adverse effects were exhibited after CABG using the DLFCA graft in this early and midterm follow-up period. The excellent patency rate of DLFCA and the low incidence of spasm stimulate us to continue and extend the use of the DLFCA in CABG.
Authors:
Mario Fabbrocini; Khalil Fattouch; Glauco Camporini; Gloria DeMicheli; Carla Bertucci; Paolo Cioffi; Domenico Mercogliano
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-25     Completed Date:  2003-07-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1836-41     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Nuova Casa di Cura Città di Alessandria, Alessandria, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arteries / transplantation*
Coronary Angiography
Coronary Artery Bypass / methods*
Coronary Restenosis / etiology,  mortality,  radiography
Coronary Stenosis / mortality,  radiography,  surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications / etiology*,  mortality,  radiography
Survival Analysis

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


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