Coronary Artery Bypass Grafting Using Sequential Graft of the Left Internal Mammary Artery

내유동맥 연쇄문합술을 이용한 관동맥우회로 이식술

  • 오상기 (전남대학교 의과대학 흉부외과학교실)
  • Published : 2000.02.01

Abstract

Background: As the internal mammary artery is far superior to the vein in the patency rate recently there has been a tendency to use the arterial graft as much as possible in coronary artery bypass grafts with the expectation of better the short- and long-term patency rate. Material and Method: We sequentially grafted the diagonal and the left anterior descending artery significantly influencing the cardiac function with the internal mammary artery. There were 32 cases of sequential grafts from July 1993 to December 1998: 21 men and 11 women. The age range was from 43 to 69 years with a mean age of 56.64$\pm$6.41 years. There were 22 unstable angina 7 stable angina and 3 acute myocardial infarction. 8 cases of them were accompanied by stenosis of the left main coronary artery. The grafts for coronary artery bypass surgery included the great saphenous vein at 60 the right gastroepiploci artery at 5 and the left internal mammary artery at 64 coronary arteries. Result: One patient died from sepsis and multiorgan failure. Complications included wound infections in two cases and gastrointestinal bleeding in one patient. All patients showed decrease or disappearance of angina after operation. The postoperative coronary angiogram performed in 9 patients showed neither occlusion nor stenosis of the grafts. Conclusion: This study suggests that sequential anastomosis of the internal mammary artery to the diagonal and the left anterior descending artery may result in excellent short-term patency diagonal and the left anterior descending artery may result in excellent short-term patency rate and be useful for the coronary artery bypass graft using only arterial grafts

Keywords

References

  1. J Thorac Cardiovasc Surg v.90 Twelve-year experience with internal mammary artery for coronary artery bypass Barner HB.;Standevev JW.;Reese J.
  2. Ann Thorac Surg v.36 Multivessel coronary revascularization without saphenous vein;long-term results of bilateral internal mammary artery grafting Lytle BW.;Cosgrove DM.;Saltus GL.;et al.
  3. Circulation v.46 no.SUP.12 Anastomosis of the internal mammary artery to the distal feft anterior descending coronary artery Greeen GE.;Stertzer SH.;Gordon RB.;Spence R.;Tice DA.
  4. Ann Thorac Surg v.41 Coronary bypass surgery highlights blood vessel biology Green G.
  5. J Thorac Cardiovac Surg v.75 Optimal patency rates obtained in coronary artery grafting with circular vein grafts Gordin CM.;Vouhe P.;Bourassa MG.
  6. Ann Thorac Surg v.41 Physiological adaptability;the secret of success of the internal mammary artery grafts Singh RN.;Beg RA.;Kay EB.
  7. Lancet v.2 Atherosclerosis in aortocoronary vein grafts Barboriak JJ.;Pintar K.;Korns ME.
  8. Ann Thorac Surg v.20 Comparative hemodynamic properties of vein and mammary artery in coronary bypass operation Flemma RJ.;Singh HM.;Tector AJ.;Lepley D.;Frasier BL.
  9. J Cardiovascu Surg v.29 Sequential coronary artery bypass utilizing the internal mammary artery Boustany CW Jr.;Mills NL.
  10. J Thorac Cardiovasc Surg v.86 Sequential internalmammary-coronary artery bypass Sami SK.;Elias SH.;Tali TB.;John RC.;David GF.
  11. J Thorac Cardiovasc Surg v.80 Bypass grafts to the left anterior descending coronary artery Tyras DH.;Barner HB.;Kaiser GC.;et al.
  12. J Thorac Cardiovasc Surg v.81 Arationale for the use of suquential coronary artery bypass grafts O'Neil MJ.;Wolf PD.;O'Neil TK.;Montesano RM.
  13. J Thorac Cardiovasc Surg v.70 Selection of coronary bypass Anatomic Physiological and angiographic considerations of vein and ammmary artery grafts Geha AS.;Krone RJ.;McCormic JR.
  14. Ann Thorac Surg v.30 Current controversies in the conduct of the coronary Ullyot DJ.
  15. J Thorac Cardiovasc Surg v.92 Clinical and angiographic assessment of complex mammary artery bypass grafting Rankin JS.;Newman GE.;Bashore TM.;et al.
  16. J Thorac Cardiovasc Surg v.98 Sequential mammary grafting Dion R.;Verhelst R.;Rousseau M.;et al.