| The Long-Term Results of Left Internal Thoracic Artery Grafting in the Left Anterior Descending Artery with Either a Sternotomy or an Anterior Minithoracotomy |
(Department of Cardiovascular Surgery, Fukuoka University, School of Medicine, Fukuoka, Japan)
| Hidehiko Iwahashi |
Tadashi Tashiro |
Noritugu Morishige |
| Yoshio Hayashida |
Nobuhisa Ito |
Kazuma Takeuchi |
| Hideki Teshima |
Go Kuwahara |
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The main objective of this
study was to describe the long-term results of left internal
thoracic artery grafting of the left anterior descending
artery with a sternotomy or anterior minithoracotomy without
using extracorporeal circulation. From March 1997 to February
2000, a median sternotomy was performed in 8 patients
and a minithoracotomy in 22 patients. We compared and
analyzed the findings of these groups. An emergency operation
was performed in 75% of the patients in the median sternotomy
group and in 27.3% of those in the minithoracotomy group
(p＝0.03). The operation time was 2.1h
in the median sternotomy group and 3.9h in the minithoracotomy
group (p＜0.01). The early graft patency rate was 100%
in the median sternotomy group and 90.4% in the minithoracotomy
group (NS). The five-year actuarial survival rate was
100% in the median sternotomy group and 86.4% in the minithoracotomy
group. The five-year cardiac event free rate was 100%
in the median sternotomy group and 86.4% in the minithoracotomy
group. In conclusion, the results for the median sternotomy
group were comparatively better than for minithoracotomy
group. Minithoracotomy and median sternotomy have differences
in operation time, early graft patency and early outcome.
The median sternotomy technique therefore remains an invaluable
operative modality for the treatment of one-vessel disease.
Jpn. J. Cardiovasc. Surg. 36: 245-247 (2007) |
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