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Complete revascularization with three or more arterial conduits.
Semin Thorac Cardiovasc Surg. 1996 Jan; 8(1):15-23.ST

Abstract

A complete revascularization with three or more arterial conduits was achieved, giving the patient, if possible, three blood sources from the in situ arterial grafts (skeletonized bilateral internal thoracic arteries [ITAs] and right gastroepiploic artery). If one of these conduits was not available, a radial artery was used, the proximal anastomosis being constructed on an ITA. The inferior epigastric artery was used if a sequential anastomosis was not advisable or to lengthen another arterial graft. With this strategy, 247 patients underwent surgery from October 1991 through April 1995; 774 arterial conduits were used: 244 left ITAs, 187 right ITAs, 159 right gastroepiploic arteries, 114 radial arteries, and 70 inferior epigastric arteries. The in-hospital and late mortality rates were 1.2% (3 patients) and 1.6% (4 patients), respectively. Of the 240 patients alive, 235 (97.9%) are asymptomatic. We compared the 42-month survival and event-free survival curves of these patients with those of an historical cohort of patients who underwent surgery with mixed (1 left ITA and saphenous vein grafts) revascularization. Whereas the survival rate was similar (97.82% +/- 1.11% vs 99.35% +/- 0.65, P = .174), the event-free survival rate was significantly better in the total arterial group (93.72% +/- 2.1 % vs 85.62% +/- 2.84%, P = .021). We conclude that complete revascularization with three or more arterial conduits is technically feasible with a low mortality rate; the mid-term results allow us to continue this strategy of myocardial revascularization.

Authors+Show Affiliations

Division of Cardiac Surgery, University of Chieti, Italy.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8679746

Citation

Calafiore, A M., and G Di Giammarco. "Complete Revascularization With Three or More Arterial Conduits." Seminars in Thoracic and Cardiovascular Surgery, vol. 8, no. 1, 1996, pp. 15-23.
Calafiore AM, Di Giammarco G. Complete revascularization with three or more arterial conduits. Semin Thorac Cardiovasc Surg. 1996;8(1):15-23.
Calafiore, A. M., & Di Giammarco, G. (1996). Complete revascularization with three or more arterial conduits. Seminars in Thoracic and Cardiovascular Surgery, 8(1), 15-23.
Calafiore AM, Di Giammarco G. Complete Revascularization With Three or More Arterial Conduits. Semin Thorac Cardiovasc Surg. 1996;8(1):15-23. PubMed PMID: 8679746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complete revascularization with three or more arterial conduits. AU - Calafiore,A M, AU - Di Giammarco,G, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 15 EP - 23 JF - Seminars in thoracic and cardiovascular surgery JO - Semin Thorac Cardiovasc Surg VL - 8 IS - 1 N2 - A complete revascularization with three or more arterial conduits was achieved, giving the patient, if possible, three blood sources from the in situ arterial grafts (skeletonized bilateral internal thoracic arteries [ITAs] and right gastroepiploic artery). If one of these conduits was not available, a radial artery was used, the proximal anastomosis being constructed on an ITA. The inferior epigastric artery was used if a sequential anastomosis was not advisable or to lengthen another arterial graft. With this strategy, 247 patients underwent surgery from October 1991 through April 1995; 774 arterial conduits were used: 244 left ITAs, 187 right ITAs, 159 right gastroepiploic arteries, 114 radial arteries, and 70 inferior epigastric arteries. The in-hospital and late mortality rates were 1.2% (3 patients) and 1.6% (4 patients), respectively. Of the 240 patients alive, 235 (97.9%) are asymptomatic. We compared the 42-month survival and event-free survival curves of these patients with those of an historical cohort of patients who underwent surgery with mixed (1 left ITA and saphenous vein grafts) revascularization. Whereas the survival rate was similar (97.82% +/- 1.11% vs 99.35% +/- 0.65, P = .174), the event-free survival rate was significantly better in the total arterial group (93.72% +/- 2.1 % vs 85.62% +/- 2.84%, P = .021). We conclude that complete revascularization with three or more arterial conduits is technically feasible with a low mortality rate; the mid-term results allow us to continue this strategy of myocardial revascularization. SN - 1043-0679 UR - https://www.unboundmedicine.com/medline/citation/8679746/Complete_revascularization_with_three_or_more_arterial_conduits_ DB - PRIME DP - Unbound Medicine ER -