| Coronary Artery Bypass Grafting Using
in Situ Bilateral Internal Thoracic Arteries |
(Department of Cardiovascular Surgery,
Kochi Municipal Hospital Kochi, Japan)
| Tomoaki Suzuki |
Manabu Okabe |
Fuyuhiko Yasuda |
| Yoichiro Miyake |
Satofumi Tanaka |
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Coronary artery bypass
grafting (CABG) using in situ skeletonized arterial
conduits with an off-pump technique is a high quality
and minimally invasive procedure. The internal
thoracic artery (ITA) is the most reliable conduit as
grafting the left anterior descending artery and
circumflex arteries with bilateral ITAs leads to
better long-term patient outcomes. In this study,
we demonstrated the feasibility and usefulness of
off-pump coronary artery bypass grafting surgery
using bilateral ITAs. A total of 217 consecutive
CABG cases using skeletonized ITA grafts were studied
and they were divided into 2 groups are using unilateral
ITA (UITA, n＝104) and the other using bilateral
ITA (BITA, n＝113). OPCAB was completed in 94% (98/104)
in the UITA group and in 99% (112/113) in the BITA group.
The mean number of distal anastomoses per patient
was 3.02 in the UITA group and 3.63 in the BITA group.
The ITAs were used in situ in 100% (104 ITAs) in the UITA
group and in 96% (217 ITAs) in the BITA group.
One patient in the UITA group suffered from mediastinitis
and one patient in the BITA group died due to intestinal
ischemia 3 days after operation. Postoperative
angiography was performed before discharge in 101 patients
in UITA and 99 in BITA. The patency rate was 98.7% in the
UITA group and 99.4% in the BITA group. OPCAB with
bilateral skeltonized ITAs is a feasible and safe
technique with excellent early clinical results and
graft patency. OPCAB using in situ skeletonized artery
conduits can become a standard surgical treatment for
ischemic heart disease.
Jpn. J. Cardiovasc. Surg. 34: 176-179 (2005) |
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