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[Coronary revascularization with the internal thoracic artery. Angiographic controls in 86 patients]
R Schräder1, L Gusić, W D Bussmann
1Abteilung für Kardiologie, Klinikum der Universität, Frankfurt am Main.
Insights
Internal mammary artery grafts show high patency rates (83.7%) after coronary revascularization, outperforming venous grafts (64.5%). These findings support the internal mammary artery as the preferred graft for improved long-term results.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Coronary Artery Disease
Background:
- Coronary revascularization is a critical procedure for managing coronary artery disease.
- Graft selection significantly impacts long-term patient outcomes.
- Internal mammary artery (IMA) and venous grafts are commonly used conduits.
Purpose of the Study:
- To evaluate the postoperative patency rates of internal mammary artery (IMA) grafts compared to aortocoronary venous grafts.
- To assess the long-term efficacy of IMA grafts in patients undergoing coronary revascularization.
Main Methods:
- Retrospective analysis of 454 patients undergoing coronary revascularization between November 1984 and October 1987.
- Postoperative angiography performed in 86 patients (18.9%) at varying intervals (median 47 weeks).
- Patency rates for IMA grafts and venous grafts were calculated and compared.
Main Results:
- The mean patency rate for IMA grafts was 83.7% (72/86), showing an increase over time (71% in 1984/85 to 92% in 1987).
- The patency rate for venous grafts was 64.5% (78/121).
- Higher patency rates for IMA grafts suggest better long-term graft performance.
Conclusions:
- Internal mammary artery grafts demonstrate superior patency rates compared to venous grafts in coronary revascularization.
- The findings support the use of IMA grafts as the preferred option for improved long-term outcomes in coronary artery bypass surgery.
- Potential for even higher patency rates in the entire cohort due to refusal of angiography by asymptomatic patients.
Abstract:
Among a cohort of 454 consecutive patients who had undergone coronary revascularization with the internal mammary artery (from November 1984 to October 1987), postoperative angiography was performed in 86 (18.9%) (77 males and 9 females, aged 33-74 years; median age 56 years). The interval between operation and angiography ranged from one week to 26 months (median 47 weeks). The mean patency rate for the internal mammary artery grafts was 83.7% (72 of 86 grafts), the patency rate having increased from 71% in 1984/85 to 92% in 1987. In the same cohort the patency rate of venous grafts was 64.5% (78 of 121 aortocoronary venous grafts). Many asymptomatic patients refused follow-up angiography; the patency rate is therefore likely to have been higher for the entire cohort. The high patency rate and good long-term results for internal mammary artery grafts support the view that this type of graft is preferable to others for coronary revascularization.