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Andrew C. Fiore
Keith S. Naunheim
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Ann Thorac Surg 1990;49:202-209
© 1990 The Society of Thoracic Surgeons


Articles

Results of internal thoracic artery grafting over 15 years: Single versus double grafts

Andrew C. Fiore, MD*, Keith S. Naunheim, MD, Phillip Dean, MD, George C. Kaiser, MD, D.Glenn Pennington, MD, Vallee L. Willman, MD, Lawrence R. McBride, MD, Hendrick B. Barner, MD

Divisions of Cardiothoracic Surgery, St. Mary's Health Center and St. Louis University Medical Center, St. Louis, Missouri USA

* Address reprint requests to Dr Fiore, St. Mary's Health Center, 6420 Clayton Rd, St. Louis, MO 63117.

One hundred consecutive patients who had coronary artery bypass grafting using both internal thoracic arteries (ITAs) and saphenous veins, operated on during a 3-year period between 1972 and 1975, have been compared retrospectively with a series of 100 patients operated on during the same period who had one ITA graft along with saphenous vein grafts. The two groups were similar with respect to age, sex, risk factors for coronary artery disease, angina class, extent of coronary artery disease, left ventricular function, number of coronary bypass grafts performed, and completeness of revascularization. Single ITA operative mortality was 2% and double ITA, 9% (p = NS). The mean follow-up of hospital survivors was 14.4 ± 2.7 years; all but 7 patients had follow-up for at least 10 years. At 13 years, the actuarial patency of the right ITA was 85% and the left ITA, 82%. These data strongly suggest a survival benefit for patients with double ITA grafts among hospital survivors (74% versus 59%; p = 0.05). Patients receiving two ITA grafts had a significant freedom from subsequent myocardial infarction (75% versus 59%, p < 0.025), recurrent angina pectoris (36% versus 27%, p < 0.025), and subsequent total ischemic events (32% versus 18%, p < 0.01). These data also suggest improved freedom from coronary artery interventional therapy (percutaneous transluminal coronary angioplasty and reoperation) when two ITA grafts were used. These results support the use of bilateral internal thoracic artery grafting in selected patients.




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CirculationHome page
C. A. Dietl, C. H. Benoit, C. L. Gilbert, E. L. Woods, W. F. Pharr, M. D. Berkheimer, N. P. Madigan, and F. J. Menapace
Which Is the Graft of Choice for the Right Coronary and Posterior Descending Arteries? : Comparison of the Right Internal Mammary Artery and the Right Gastroepiploic Artery
Circulation, November 1, 1995; 92(9): 92 - 97.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
A. M. Calafiore, G. Di Giammarco, G. Teodori, E. D'Annunzio, G. Vitolla, C. Fino, and N. Maddestra
Radial artery and inferior epigastric artery in composite grafts: Improved midterm angiographic results
Ann. Thorac. Surg., September 1, 1995; 60(3): 517 - 524.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
E. Berreklouw, J. P. A. M. Schonberger, H. Ercan, E. L. Koldewijn, M. de Bock, V. J. Verwaal, F. van der Linden, I. van der Tweel, J. H. Bavinck, and J. J. Bredee
Does it make sense to use two internal thoracic arteries?
Ann. Thorac. Surg., June 1, 1995; 59(6): 1456 - 1463.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
O. Jegaden, A. Eker, P. Montagna, J. Ossette, G. De Gevigney, G. Finet, A. S. Pierre, D. Revel, R. Itti, and P. H. Mikaeloff
Risk and results of bypass grafting using bilateral internal mammary and right gastroepiploic arteries
Ann. Thorac. Surg., April 1, 1995; 59(4): 955 - 960.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
A. M. Calafiore, G. Di Giammarco, N. Luciani, N. Maddestra, E. Di Nardo, and R. Angelini
Composite arterial conduits for a wider arterial myocardial revascularization
Ann. Thorac. Surg., July 1, 1994; 58(1): 185 - 190.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
E. Berreklouw, J. P. A. M. Schonberger, J. H. Bavinck, V. J. Verwaal, E. L. Koldewijn, F. van Der Linden, I. Van der Tweel, and J. J. Bredee
Similar hospital morbidity with the use of one or two internal thoracic arteries
Ann. Thorac. Surg., June 1, 1994; 57(6): 1564 - 1572.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
E. Petrossian, M. A. Menegus, H. J. Issenberg, A. Jones, R. Frame, and R. F. Brodman
Ultrasound evaluation of the inferior epigastric artery
Ann. Thorac. Surg., April 1, 1994; 57(4): 895 - 898.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
F. L. Grover, R. R. Johnson, G. Marshall, K. E. Hammermeister, and Department of Veterans Affairs Cardiac Surgeons
Impact of mammary grafts on coronary bypass operative mortality and morbidity
Ann. Thorac. Surg., March 1, 1994; 57(3): 559 - 569.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
F. H. Edwards, R. E. Clark, and M. Schwartz
Impact of internal mammary artery conduits on operative mortality in coronary revascularization
Ann. Thorac. Surg., January 1, 1994; 57(1): 27 - 32.
[Abstract] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
G.-W. He, W. H. Ryan, T. E. Acuff, R. T. Bowman, M. B. Douthit, C.-Q. Yang, and M. J. Mack
Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting
J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 196 - 202.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
L. P. Perrault, M. Carrier, Y. Hebert, G. Hudon, R. Cartier, Y. Leclerc, and L. C. Pelletier
Clinical experience with the right gastroepiploic artery in coronary artery bypass grafting
Ann. Thorac. Surg., November 1, 1993; 56(5): 1082 - 1084.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
G. M. Palatianos, H. Bolooki, M. D. Horowitz, M. H. Lowery, S. P. Rosenthal, S. K. C. Chandarlapaty, G. N. Sfakianakis, and G. A. Kaiser
Sequential internal mammary artery grafts for coronary artery bypass
Ann. Thorac. Surg., November 1, 1993; 56(5): 1136 - 1140.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
K. D. Accola, E. L. Jones, J. M. Craver, W. S. Weintraub, and R. A. Guyton
Bilateral mammary artery grafting: Avoidance of complications with extended use
Ann. Thorac. Surg., October 1, 1993; 56(4): 872 - 879.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
J. Ramstrom, O. Lund, E. Cadavid, S. Oxelbark, J. B. Thuren, and A. C. Henze
Right internal mammary artery for myocardial revascularization: Early results and indications
Ann. Thorac. Surg., June 1, 1993; 55(6): 1485 - 1491.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
J. A. M. van Son, F. Smedts, P. C. M. de Wilde, N. H. J. Pijls, L. Wong-Alcala, K. Kubat, G. Tavilla, and L. K. Lacquet
Histological study of the internal mammary artery with emphasis on its suitability as a coronary artery bypass graft
Ann. Thorac. Surg., January 1, 1993; 55(1): 106 - 113.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
J. M. Cunningham, M. A. Gharavi, R. Fardin, and R. A. Meek
Considerations in the skeletonization technique of internal thoracic artery dissection
Ann. Thorac. Surg., November 1, 1992; 54(5): 947 - 950.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
K. S. Naunheim, H. B. Barner, and A. C. Fiore
Results of internal thoracic artery grafting over 15 years: single versus double grafts
Ann. Thorac. Surg., April 1, 1992; 53(4): 716 - 718.
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Ann. Thorac. Surg.Home page
M. Carrier, J. Gregoire, F. Tronc, R. Cartier, Y. Leclerc, and L.-C. Pelletier
Effect of internal mammary artery dissection on sternal vascularization
Ann. Thorac. Surg., January 1, 1992; 53(1): 115 - 119.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
G. K. Sethi, J. G. Copeland, T. Moritz, W. Henderson, K. Zadina, and S. Goldman
Comparison of postoperative comlications between saphenous vein and IMA grafts to left anterior descending coronary artery
Ann. Thorac. Surg., May 1, 1991; 51(5): 733 - 738.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
I. F. Galvin
Mammary artery grafts: A new no-touch technique for anastomosis
Ann. Thorac. Surg., March 1, 1991; 51(3): 500 - 503.
[Abstract] [PDF]


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JAMAHome page
F. M. Lupinetti and D. M. Behrendt
Cardiothoracic Surgery
JAMA, May 16, 1990; 263(19): 2627 - 2629.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
N. T. Kouchoukos, T. H. Wareing, S. F. Murphy, C. Pelate, and W. G. Marshall Jr
Risks of bilateral internal mammary artery bypass grafting
Ann. Thorac. Surg., February 1, 1990; 49(2): 210 - 219.
[Abstract] [PDF]




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