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Complete revascularization with three or more arterial conduits

A M Calafiore1, G Di Giammarco

  • 1Division of Cardiac Surgery, University of Chieti, Italy.

Seminars in Thoracic and Cardiovascular Surgery
|January 1, 1996
PubMed
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Complete arterial revascularization using multiple grafts offers excellent long-term outcomes. This strategy demonstrates improved event-free survival compared to traditional methods, with low mortality rates.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Vascular Surgery

Background:

  • Coronary artery disease necessitates effective revascularization strategies.
  • Optimizing graft choice and number is crucial for long-term patient outcomes.

Purpose of the Study:

  • To evaluate the feasibility and mid-term results of complete arterial revascularization using three or more arterial conduits.
  • To compare event-free survival rates between total arterial grafts and conventional mixed grafts.

Main Methods:

  • Surgical technique involved using skeletonized bilateral internal thoracic arteries (ITAs) and the right gastroepiploic artery, supplemented by radial or inferior epigastric arteries as needed.
  • A cohort of 247 patients received complete arterial revascularization between October 1991 and April 1995.

Related Experiment Videos

  • Outcomes were compared to a historical cohort using one left ITA and saphenous vein grafts.

    • Main Results:

    • A total of 774 arterial conduits were used across the patient cohort.
    • In-hospital and late mortality rates were low at 1.2% and 1.6%, respectively.
    • Event-free survival was significantly better in the total arterial group (93.72%) compared to the mixed graft group (85.62%), P = .021.

    Conclusions:

    • Complete revascularization with three or more arterial conduits is technically feasible.
    • This strategy yields low mortality and favorable mid-term event-free survival.
    • The study supports the continued use of total arterial grafting for myocardial revascularization.