Complete Revascularization Using a Patent Left Internal Thoracic Artery and Variable Arterial Grafts in Multivessel Coronary Reoperation
- Authors
- Min, HK[Min, Ho-Ki]; Lee, YT[Lee, Young Tak]; Kim, WS[Kim, Wook Sung]; Yang, JH[Yang, Ji-Hyuk]; Sung, K[Sung, Kiick]; Jun, TG[Jun, Tae-Gook]; Park, PW[Park, Pyo Won]
- Issue Date
- Oct-2009
- Publisher
- FORUM MULTIMEDIA PUBLISHING, LLC
- Citation
- HEART SURGERY FORUM, v.12, no.5, pp.E244 - E249
- Indexed
- SCIE
SCOPUS
- Journal Title
- HEART SURGERY FORUM
- Volume
- 12
- Number
- 5
- Start Page
- E244
- End Page
- E249
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/76894
- DOI
- 10.1532/HSF98.20091028
- ISSN
- 1098-3511
- Abstract
- Background: Arterial grafting and complete revascularization are important requirements of coronary surgery to achieve optimum long-term results. In cases involving coronary artery bypass grafting reoperation (redo-CABG), it is sometimes difficult to satisfy these requirements because of the limited availability of grafts. In this study, we constructed composite and sequential grafting with a minimal number of new arterial grafts and a patent left internal thoracic artery (LITA), which sometimes is encountered in preoperative angiography, and we analyzed the results of redo-CABG. Methods: Between January 2005 and October 2008, 29 patients underwent redo-CABG. Ten patients who had a patent LITA graft in situ were reviewed retrospectively. We performed conventional CABG in 8 patients and on-pump beating-heart CABG in 2 patients. The new arterial grafts for the composite grafts included 7 LITAs and 3 radial arteries. The types of composite grafts included 7 Y grafts, 1 K graft, 1 X graft, and 1 double-Y graft. Overall, we performed 28 distal anastomoses (mean per patient, 2.8 +/- 0.7), of which 18 anastomoses were supplied from a patent LITA (mean, 1.8 +/- 0.4). Results: No hospital deaths occurred, and perioperative complications included injury to a LITA, low cardiac output, delirium, and postoperative bleeding in 1 patient each. The mean duration of follow-up was 23.6 +/- 16.8 months (range, 2-46 months). There was 1 late death and no recurrent angina during the follow-up period. Follow-up coronary images obtained for 7 patients showed that all of the anastomoses were patent. Conclusion: Composite and sequential grafting with new arterial grafts and a patent LITA is a safe and effective alternative in patients with multivessel disease undergoing redo-CABG.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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