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Purely internal thoracic artery grafts: outcomes
A J Tector1, M L McDonald, D C Kress
1Midwest Heart Surgery Institute, St Luke's Medical Center, Milwaukee, Wisconsin, USA. tector@execpc.com
The Annals of Thoracic Surgery
|August 23, 2001
Summary
Purely internal thoracic artery (PITA) grafts offer long-term benefits for coronary artery disease patients. An 8.5-year study shows high freedom from reintervention, supporting PITA use in bypass surgery.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Coronary artery disease (CAD) management often involves coronary artery bypass grafting (CABG).
- Purely internal thoracic artery (PITA) grafts are frequently utilized for CABG.
- Optimizing long-term outcomes and graft patency is crucial for CABG patients.
Purpose of the Study:
- To evaluate the long-term outcomes of coronary artery bypass operations using purely internal thoracic artery (PITA) grafts.
- To assess mortality and reintervention rates in patients undergoing PITA bypass over an 8.5-year period.
Main Methods:
- A retrospective study of 897 patients who underwent CABG using PITA grafts.
- A total of 3,784 internal thoracic artery (ITA) grafts were used, averaging 4.2 grafts per patient.
- The surgical technique involved connecting ITA to ITA with sequential anastomoses.
Main Results:
- The early mortality rate was 2.3%.
- At 5 years post-operation, freedom from death was 86%.
- Freedom from reintervention was 94% at 5 years, extending to 8.5 years.
Conclusions:
- PITA grafting demonstrates acceptable early and late mortality rates.
- High rates of freedom from reintervention (94% up to 8.5 years) support the continued use of PITA.
- PITA is a viable and effective option for patients with three-vessel coronary artery disease.