Abstract
To evaluate the long-term results of the coronary artery bypass grafting with exclusive use of arterial grafts for patients with triple vessel disease. We evaluated 136 patients who underwent isolated coronary artery bypass grafting between January 1995 and December 1997. 353 grafts were used for revascularization of 449 arteries (mean: 3.30 per patient). Grafts used were left internal thoracic artery (99.2%), right internal thoracic artery (56.6%), radial artery (87.5%), right gastroepiploic artery (20.5%) and one inferior epigastric artery. 76 (55.8%) patients received composite grafts ('Y' shape) and 66 (48.5%) patients received sequential anastomoses. Hospital mortality was 4.4%. In the long-term follow-up (9.5 to 12.8 years), 82.1% of the patients were free of cardiac events. 20 (17.9%) patients had hospital readmission due to cardiac events: 15 presented angina and five presented acute myocardial infarction, and three of them presented associated heart failure. Eighth (7.1%) patients needed coronary reintervention: one of them underwent coronary bypass reoperation and the others underwent coronary angioplasty with stent. Estimated probability of cardiac event-free was 98.2%, 95.4% e 84.2% at 1, 5 and 10 years follow-up respectively. There were 16 (14.2%) late deaths and four of them (3.6%) were cardiac-related. Actuarial 12.8-year-survival of all deaths was 85% in this group. Coronary artery bypass grafting with exclusive use of arterial grafts is a safe procedure for patients with triple vessel coronary disease with good long-term results.
Highlights
Surgical coronary artery bypass grafting (CABG) has attained great importance since its beginning in the middle of the 1960s
Coronary artery bypass grafting with the exclusive use of arterial grafts is a safe procedure for patients with triple vessel coronary disease with good long-term results
Myocardial revascularization surgery utilizing a combination of the left internal thoracic artery (LITA) with saphenous vein bypasses became the standard procedure in the treatment of coronary artery disease; a conduct that persists until today in the majority of heart surgery centers
Summary
Surgical coronary artery bypass grafting (CABG) has attained great importance since its beginning in the middle of the 1960s. The saphenous vein was always the most commonly used graft for CABG [1,2], but at the end of the 1970s the left internal thoracic artery (LITA) graft started to be utilized more frequently [3]. Myocardial revascularization surgery utilizing a combination of the LITA with saphenous vein bypasses became the standard procedure in the treatment of coronary artery disease; a conduct that persists until today in the majority of heart surgery centers. Many works have reported better results with the use of the LITA [6]. There is, the expectation that myocardial revascularization with the exclusive use of arterial grafts will improve these results even further, a view supported by some studies [9,10,11,12]
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