A G Royse1, C F Royse, J S Raman. 1. Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia. alistair.royse@nwhcn.org.au
Abstract
BACKGROUND: The pedicled (in-situ) left internal mammary artery grafted to the left anterior descending artery has a very high late patency and reduces late mortality following coronary artery bypass surgery. A technique is described which achieves total arterial revascularization in patients with multivessel coronary disease and which is also entirely pedicled. METHODS: Using the left internal mammary artery and radial artery joined as a composite Y graft, all coronary territories may be grafted. RESULTS: One in-hospital death from 464 patients (0.2%) occurred. Age (mean +/- standard error) was 64.7 +/- 0.5 years and number of distal anastomoses 3.4 +/- 0.04. Of 1,681 patients from Royal Melbourne Hospital, 346 had this operation. Comparison found no preoperative selection bias and no postoperative differences in complications. Actuarial survival was 0.98 +/- 0.01 at 36.1 +/- 0.3 months. CONCLUSIONS: Total arterial revascularization may be performed using the left internal mammary artery and radial artery as a composite Y graft. There was no increase in complications. This technique preserves the left internal mammary artery to left anterior descending artery graft.
BACKGROUND: The pedicled (in-situ) left internal mammary artery grafted to the left anterior descending artery has a very high late patency and reduces late mortality following coronary artery bypass surgery. A technique is described which achieves total arterial revascularization in patients with multivessel coronary disease and which is also entirely pedicled. METHODS: Using the left internal mammary artery and radial artery joined as a composite Y graft, all coronary territories may be grafted. RESULTS: One in-hospital death from 464 patients (0.2%) occurred. Age (mean +/- standard error) was 64.7 +/- 0.5 years and number of distal anastomoses 3.4 +/- 0.04. Of 1,681 patients from Royal Melbourne Hospital, 346 had this operation. Comparison found no preoperative selection bias and no postoperative differences in complications. Actuarial survival was 0.98 +/- 0.01 at 36.1 +/- 0.3 months. CONCLUSIONS: Total arterial revascularization may be performed using the left internal mammary artery and radial artery as a composite Y graft. There was no increase in complications. This technique preserves the left internal mammary artery to left anterior descending artery graft.
Authors: B J Wintersperger; G Bastarrika; K Nikolaou; C Rist; A Huber; A Knez; M F Reiser; C R Becker; C Vicol Journal: Radiologe Date: 2004-02 Impact factor: 0.635
Authors: Christian L Carranza; Martin Ballegaard; Mads U Werner; Philip Hasbak; Andreas Kjær; Klaus F Kofoed; Jane Lindschou; Janus Christian Jakobsen; Christian Gluud; Peter Skov Olsen; Daniel A Steinbrüchel Journal: Trials Date: 2014-04-23 Impact factor: 2.279