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Published on: March 27, 2018
Coronary artery bypass grafting using both internal mammary arteries in patients with diabetes mellitus
Stevan Krieger Martins1, Magaly Arrais dos Santos, Freddy H Ponce Tirado
1Hospital do Coração - HCor, São Paulo, SP. smartins@hcor.com.br
Objective:
We sought to describe the use of both internal mammary arteries (IMA) in patients with diabetes mellitus (DM) submitted to coronary artery bypass grafting (CABG).
Method:
Between January of 1995 to August of 2005, 4.569 patients received isolated CABG in our institution, of these, 1.298 had DM. Mean sample age was 62 years, and total mortality was 2.18% (100 patients). We have used both IMA's in 700 patients, that here are split in two groups, with DM (group I, 148 patients), and without DM (group II, 552 patients). Patient selection for double IMA grafting was based on coronary artery anatomy and sternal bone quality, the later was evaluated during sternal transsection. When these two factors were considered favorable, we harvested both IMA's, not mattering if the patient had or had not DM. During IMA's harvest, care was taken not to open the pleural spaces.
Results:
There was small difference between the two groups in terms of morbidity and mortality.
Conclusion:
Our data suggest that patients with DM can benefit of double IMA's grafting, with little increase in risk for complications if its application is carefully indicated.
