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Ann Surg. 2001 Oct;234(4):447-52; discussion 452-3.

Midterm results of complete arterial revascularization in more than 1,000 patients using an internal thoracic artery/radial artery T graft.

Author information

1
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. barnerh@msnotes.wustl.edu

Abstract

OBJECTIVE:

To report the authors' 7-year experience with the internal thoracic artery/radial artery (ITA/RA) T graft as the only conduits for myocardial revascularization in two- and three-vessel disease.

SUMMARY BACKGROUND DATA:

One and two arterial conduits provide increasing survival benefit for coronary grafting and reduce the need for reintervention. Exclusive use of arterial conduits may provide further benefit.

METHODS:

From October 1993 to November 2000, 1,020 patients underwent complete arterial revascularization with the ITA/RA T graft. The authors focus on the 909 having initial bypass, with a mean age of 60 and 20% age 70 or older. The incidence of triple-vessel disease was 73%, female gender 28%, diabetes mellitus 27%, peripheral vascular disease 11%, cerebrovascular disease 10%, and chronic obstructive pulmonary disease 6%; ejection fraction was less than 35% in 11%. Perioperative data were collected prospectively. Follow-up information was obtained at a mean of 35.4 months (range 1-88) and was 95% complete.

RESULTS:

There were seven (0.08%) deaths within 30 days of surgery. The incidence of perioperative infarction was 3.3%, low cardiac output 2.7%, stroke 2.2%, reoperation for bleeding 3.8%, and deep sternal infection 0.8%. The actuarial survival rate was 90% at 5 years, freedom from infarction was 94%, freedom from catheterization was 83%, and freedom from reintervention (angioplasty or reoperation) was 93%.

CONCLUSION:

The ITA/RA T graft for complete arterial revascularization is associated with a low rate of perioperative death and complications and 5-year survival and freedom from reintervention values consistent with other revascularization strategies.

PMID:
11573038
PMCID:
PMC1422068
[Indexed for MEDLINE]
Free PMC Article
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