CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 3, 1998, No 1

Multiple CABG with only In Situ Arterial Conduits

H. Nishida, Y. Tomizawa, M. Endo, H. Koyanagi

Abstract:
From March 1988 to February 1997, 181 patients (167 men, 14 women, mean age 60.0 years, range 39 to 76 years) underwent CABG with three or more distal anastomoses, using in situ arterial conduits only such as the left and right internal thoracic arteries (LITA, RITA) and right gastroepiploic artery (RGEA) (group A). The postoperative follow-up ranged from one to 108 months with a mean of 30 months. One hundred and fifty-four patients (85%) had either triple vessel or left main disease. Left ventricular ejection fraction was 40% or less in 38 patients (21%). The mean number of distal anastomoses was 3.17 per patient. Sequential grafting was performed with the LITA in 63 patients, the RGEA in 24 patients and both LITA and RGEA in 3 patients. There was one hospital death (0.6%), and 2 patients (1.1%) developed perioperative myocardial infarction. Graft patency 3 to 4 weeks after the operation was 98.3% in LITA, 99.2% in RITA and 95.7% in RGEA. The long-term results were compared with those in 391 CABG patients who received three or more distal anastomoses including saphenous vein or free arterial grafts during the same period (group C). The 7-Year actuari-al survival rate was 87.7% in group A and 81.9% in group C (p=0.28), cardiac death-free rate was 96.7% in group A and 92.6% in group C (p=0.12), cardiac event (cardiac death, myocardial infarction, PTCA, and re-CABG)-free rate was 88.0% in group A and 80.9% in group C (P=0.94), and cardiac event-free rate excluding PTCA was 98.1% in group A and 93.2% in group C (p=0.09). In conclusion, the clinical outcome of CABG with in situ arterial conduits only was satisfactory in terms of low operative risk and excellent graft patency and long-term results.

Keywords:
CABG, in situ arterial grafts, saphenous vein grafts, free arterial grafts

Address for Correspondence:

Reference:
(CVE. 1998; 3 (1): 22-25)

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