Comparison of sequential left internal thoracic artery grafting and separate left internal thoracic artery and venous grafting : A 5-year follow-up.
Title | Comparison of sequential left internal thoracic artery grafting and separate left internal thoracic artery and venous grafting : A 5-year follow-up. |
Publication Type | Journal Article |
Year of Publication | 2010 |
Authors | Wendt, D., Schmidt D., Wasserfuhr D., Osswald B., Thielmann M., Tossios P., Kühl H., Jakob H., & Massoudy P. |
Journal | Herz |
Volume | 35 |
Issue | 6 |
Pagination | 397-402 |
Date Published | 2010 Sep |
ISSN | 1615-6692 |
Keywords | Aged, Combined Modality Therapy, Coronary Angiography, Coronary Artery Bypass, Coronary Disease, Coronary Restenosis, Female, Follow-Up Studies, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Internal Mammary-Coronary Artery Anastomosis, Male, Middle Aged, Tomography, Spiral Computed, Veins |
Abstract | OBJECTIVES: The superiority of left internal thoracic artery (LITA) grafting to the left anterior descending artery (LAD) is well established. Patency rates of 80%-90% have been reported at 10-year follow-up. However, the superiority of sequential LITA grafting has not been proven. Our aim was to compare patency rates after sequential LITA grafting to a diagonal branch and the LAD with patency rates of LITA grafting to the LAD and separate vein grafting to a diagonal branch.METHODS: A total of 58 coronary artery bypass graft (CABG) patients, operated on between 01/2000 and 12/2002, underwent multi-slice computed tomography (MSCT) between 2006 and 2008. Of these patients, 29 had undergone sequential LITA grafting to a diagonal branch and to the LAD ("Sequential" Group), while in 29 the LAD and a diagonal branch were separately grafted with LITA and vein ("Separate" Group). Patencies of all anastomoses were investigated.RESULTS: Mean follow-up was 1958±208 days. The patency rate of the LAD anastomosis was 100% in the Sequential Group and 93% in the Separate Group (p=0.04). The patency rate of the diagonal branch anastomosis was 100% in the Sequential Group and 89% in the Separate Group (p=0.04). Mean intraoperative flow on LITA graft was not different between groups (69±8ml/min in the Sequential Group and 68±9ml/min in the Separate Group, p=n.s.).CONCLUSION: Patency rates of both the LAD and the diagonal branch anastomoses were higher after sequential arterial grafting compared with separate arterial and venous grafting at 5-year follow-up. This indicates that, with regard to the antero-lateral wall of the left ventricle, there is an advantage to sequential arterial grafting compared with separate arterial and venous grafting. |
DOI | 10.1007/s00059-010-3368-5 |
Alternate Journal | Herz |
PubMed ID | 20814654 |