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Composite arterial grafting with double skeletonized internal thoracic arteries.

D Pevni1, A Kramer, Y Paz

  • 1Department of Cardiac and Thoracic Surgery, The Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel. pevni@tasmc.health.gov.il

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|July 21, 2001
PubMed
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Composite arterial grafting using bilateral skeletonized internal thoracic arteries (ITAs) is a safe and effective myocardial revascularization technique. This method demonstrates excellent long-term survival and angina-free rates in patients undergoing coronary artery bypass grafting (CABG).

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Composite arterial grafting involves connecting free arterial conduits to an intact internal thoracic artery (ITA).
  • Bilateral skeletonized ITAs are utilized for enhanced arterial myocardial revascularization.
  • This technique is applied in coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To describe the technical aspects of composite grafting using bilateral skeletonized ITAs.
  • To report the outcomes and results of this surgical technique.
  • To evaluate the safety and efficacy of composite arterial grafting.

Main Methods:

  • A cohort of 1057 patients undergoing CABG with bilateral skeletonized ITAs from April 1996 to February 1999.
  • Composite arterial grafting was performed in 600 patients (57%).

Related Experiment Videos

  • Various composite graft configurations were used, including free right ITA to in-situ left ITA, and mini-composite grafts.

    • Main Results:

    • Operative mortality was 2.8%, with 1.7% deep sternal wound infections.
    • Mean follow-up was 25 months, with a 3-year survival rate of 92.5%.
    • Ninety-seven percent of surviving patients were free from angina.

    Conclusions:

    • Composite grafting with bilateral skeletonized ITAs is routinely performed.
    • This technique is considered the most appropriate arterial conduit strategy for composite grafting.
    • The study supports the routine use of this method in CABG patients.