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[Coronary artery bypass grafting with combined arterial grafts]
Y Shimoyama1, H Suma, Y Wanibuchi
1Department of Cardiovascular Surgery, Mitsui Memorial Hospital.
Insights
This study demonstrates that combined arterial grafts using the left internal mammary artery (IMA), right IMA, and right gastroepiploic artery (GEA) are safe and effective for coronary artery bypass grafting. All arterial grafts remained patent within three months post-surgery.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Surgical Outcomes
Context:
- Coronary artery bypass grafting (CABG) is a critical procedure for treating coronary artery disease.
- The use of multiple arterial grafts is an evolving strategy to improve long-term graft patency.
- This study evaluates a specific combination of arterial grafts in CABG patients.
Purpose:
- To assess the safety and efficacy of a combined arterial graft strategy in CABG.
- To evaluate the patency rates of left internal mammary artery (IMA), right IMA, and right gastroepiploic artery (GEA) grafts.
- To compare outcomes in patients receiving combined arterial grafts with or without saphenous vein grafts (SVG).
Summary:
- Forty-five patients underwent CABG using combined arterial grafts (left IMA, right IMA, GEA), with or without SVG.
- Perioperative complications included myocardial infarction in two patients (hospital deaths).
- Graft patency was high, with all arterial grafts patent and 97.7% patency for SVG within three months.
Impact:
- The combined arterial graft strategy utilizing IMAs and GEA shows promise for safe and effective CABG.
- This approach may offer improved long-term outcomes compared to traditional methods.
- Findings support the consideration of multi-arterial grafting in selected CABG patients.
Abstract:
Coronary artery bypass grafting with combined arterial graft using the left internal mammary artery (IMA), right IMA, and the right gastroepiploic artery (GEA) was performed in 45 patients with saphenous vein graft (SVG) (29 patients) or without SVG (16 patients) from February 1989 to October 1989. The left IMA was used in all patients, the right IMA was used in 9 patients, and the GEA was used in 43 patients. Perioperative myocardial infarction was noted in two patients who had hospital deaths. Reopening the chest for postoperative bleeding was performed in two patients, and the cerebral accident was noted in one patient. Fourteen patients were operated on without the requirement for blood transfusion. Studied within 3 postoperative months, all arterial grafts were patent though the patency was 97.7% (43/44) in SVG. It is concluded that the combined arterial graft utilizing the IMAs and GEA can be used safely and effectively.