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The effect of internal mammary artery grafting on the perioperative course
1Department of Anesthesiology, Maimonides Medical Center, Brooklyn, NY 11219.
Internal mammary artery (IMA) grafts are being used for myocardial revascularization with increasing frequency because of a higher 10-year patency rate and actuarial survival rate as compared to saphenous vein grafts. This study sought to evaluate whether IMA grafts are associated with an increased usage of blood and blood products, operating time, postoperative hospital stay, or incidence of reoperation due to bleeding. A total of 189 consecutive patients undergoing aortocoronary bypass procedures (group I, N = 59, with no IMA grafts; group II, N = 108, with single IMAs; and group III, N = 22, with double IMAs) were studied over 6 months. Significant differences were seen in their age (group I, 71.6 years; group II, 62.1 years; and group III, 57.1 years); cross-clamp time (62 minutes for group I, 65 minutes for group II, and 83.7 minutes for group III); and duration of operation (400 minutes for group I, 423 minutes for group II, and 501 minutes for group III). Use of blood products including packed red blood cells, fresh frozen plasma, and platelets during the operation and postoperatively was similar in all three groups. The duration of postoperative hospital stay was statistically similar for each group, being 16.6 days for group I, 13.1 days for group II, and 13.7 days for group III. The number of vessels grafted was statistically similar for groups I and II (3.1 and 3.3 vessels, respectively), but group III had a statistically larger number of vessels grafted (3.7 vessels). The reoperation rate for bleeding was similar for all three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Internal mammary artery (IMA) grafts are being used for myocardial revascularization with increasing frequency because of a higher 10-year patency rate and actuarial survival rate as compared to saphenous vein grafts. This study sought to evaluate whether IMA grafts are associated with an increased usage of blood and blood products, operating time, postoperative hospital stay, or incidence of reoperation due to bleeding. A total of 189 consecutive patients undergoing aortocoronary bypass procedures (group I, N = 59, with no IMA grafts; group II, N = 108, with single IMAs; and group III, N = 22, with double IMAs) were studied over 6 months. Significant differences were seen in their age (group I, 71.6 years; group II, 62.1 years; and group III, 57.1 years); cross-clamp time (62 minutes for group I, 65 minutes for group II, and 83.7 minutes for group III); and duration of operation (400 minutes for group I, 423 minutes for group II, and 501 minutes for group III). Use of blood products including packed red blood cells, fresh frozen plasma, and platelets during the operation and postoperatively was similar in all three groups. The duration of postoperative hospital stay was statistically similar for each group, being 16.6 days for group I, 13.1 days for group II, and 13.7 days for group III. The number of vessels grafted was statistically similar for groups I and II (3.1 and 3.3 vessels, respectively), but group III had a statistically larger number of vessels grafted (3.7 vessels). The reoperation rate for bleeding was similar for all three groups.(ABSTRACT TRUNCATED AT 250 WORDS)