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Total arterial myocardial revascularization using composite and sequential grafting with the off-pump technique
Toshihiro Fukui1, Shuichiro Takanashi, Yasuyuki Hosoda
1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan. tm-fukui@gem.hi-ho.ne.jp
The Annals of Thoracic Surgery
|July 26, 2005
Summary
Off-pump coronary artery bypass surgery using composite and sequential arterial grafting is safe and effective. This technique demonstrates excellent graft patency and low mortality, offering a viable option for myocardial revascularization.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Off-pump coronary artery bypass (CABG) surgery is increasingly utilized for myocardial revascularization.
- Various arterial grafting strategies are employed in off-pump CABG, with composite and sequential techniques gaining attention.
Purpose of the Study:
- To evaluate the outcomes of combining arterial composite and sequential grafting techniques in off-pump CABG surgery.
- To assess the safety and efficacy of this comprehensive arterial revascularization approach.
Main Methods:
- Retrospective review of 107 consecutive patients undergoing off-pump CABG with arterial composite grafting.
- Utilized left internal thoracic artery (LITA), right internal thoracic artery (RITA), radial artery (RA), and gastroepiploic artery (GEA) grafts.
- Early postoperative angiograms assessed graft patency in 97 patients.
Main Results:
- No hospital deaths occurred among the 107 patients.
- Excellent graft patency rates: LITA 100%, RA 97.3%, RITA 100%, GEA 100%.
- Low late mortality (3 non-cardiac deaths) over a mean follow-up of 22.1 months.
Conclusions:
- Total arterial revascularization using composite and sequential grafting is a safe and effective strategy in off-pump CABG.
- This approach offers durable graft function and favorable patient outcomes.