[Clinical study of two-area coronary bypass by one arterial graft]

In coronary artery bypass grafting (CABG), the possibility of scant flow of arterial graft compared with vein graft is pointed out. This study was carried out to clarify the propriety of two-area bypass by one arterial graft. CABG only with arterial graft was performed on 139 patients from 1992 to 1994, and two-area bypass by one arterial graft was carried in 34 cases (68 branches). The rate of improvement (%) was defined as follows: (number that showed improvement of regional left ventricular (LV) wall motion on post-operative LV graphy/number that showed decreased regional LV wall motion on pre-operative LV graphy) x 100. Sixty six branches were patent, and we evaluated these 66 LV regional wall motions. The rate of improvement in ischemic area was 53.8% (7/13 branches), and 38.1% (8/21 branches) in infarction areas. Compared with the control group, no significant difference was noted. These 34 cases showed no significant differences in mortality, postoperative IABP using rate, incidences of mediastinitis and pleural effusion compared with the control group. In view of good effect for LV wall motion and high safety operative results, this operation is regarded as a useful procedure for expanding indication of CABG only by arterial graft.