HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kevin D. Accola Ellis L. Jones Joseph M. Craver William S. Weintraub Robert A. Guyton Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Accola, K. D. Articles by Guyton, R. A. Search for Related Content PubMed PubMed Citation Articles by Accola, K. D. Articles by Guyton, R. A.

Ann Thorac Surg 1993;56:872-879
© 1993 The Society of Thoracic Surgeons

---

Articles

Bilateral mammary artery grafting: Avoidance of complications with extended use

Divisions of Cardiothoracic Surgery and Cardiology, Emory University School of Medicine, Atlanta, Georgia USA

^_* Address reprint requests to Dr Jones, Emory Clinic, 1365 Clifton Rd NE, Atlanta, GA 30322.

This study was undertaken to more clearly define the operative risks and appropriate strategies for the selection of patients who might be candidates for bilateral internal mammary artery grafting. A review of the 674 patients who underwent this procedure was performed over a 10-year period from January 1982 through 1991. These patients represented 5% of the 12,824 patients who underwent bypass grafting during this period. The mean patient age was 54 ± 9.4 years, and 92% of the patient were male. Diabetes was present in 17.5%, with 24% of this group insulin dependent. The ejection fraction was less than 0.50 in 26.7% and 14% had had previous bypass procedures. Hospital mortality was 1.9% (n = 13). Hospital morbidity included wound infection in 3.6%, reoperation for bleeding in 2.1%, and stroke in 1.6%. Postoperative intraaortic balloon pump support was necessary in 2.8%. Univariate and multivariate analysis revealed that advanced age, an emergent operative status, and the number of diseased vessels (especially left main obstruction) were predictors of hospital death. Except for wound infection (9.3% versus 2.5%) and length of hospital stay (10.8 ± 11.8 days versus 8.8 ± 7.6 days), the complications in diabetics were similar to those in patients without diabetes, respectively. At 5 years, freedom from death, death or infarctions, and death, myocardial infarction, or coronary reoperation was 90%, 70%, and 62%, respectively. The only significant multivariate correlates of long-term survival were diabetes and reoperative surgery.

This article has been cited by other articles:

				E. Bezon, J. N. Choplain, Y. A. Maguid, A. A. Aziz, and J. A. Barra Failure of internal thoracic artery grafts: conclusions from coronary angiography mid-term follow-up Ann. Thorac. Surg., September 1, 2003; 76(3): 754 - 759. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, M. Di Mauro, G. Di Giammarco, M. Contini, G. Vitolla, A. Lorena Iaco, C. Canosa, and S. D'Alessandro Effect of diabetes on early and late survival after isolated first coronary bypass surgery in multivessel disease J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 144 - 154. [Abstract] [Full Text] [PDF]

				Y. J. Woo and T. J. Gardner Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607. [Full Text]

				T. Hirotani, S. Shirota, Y. Cho, and S. Takeuchi Feasibility and suitability of the routine use of bilateral internal thoracic arteries Ann. Thorac. Surg., February 1, 2002; 73(2): 511 - 515. [Abstract] [Full Text] [PDF]

				Y. Nakayama, R. Sakata, and M. Ura Bilateral internal thoracic artery use for dialysis patients: does it increase operative risk? Ann. Thorac. Surg., March 1, 2001; 71(3): 783 - 787. [Abstract] [Full Text] [PDF]

				B. El Nakadi, C. Choghari, and M. Joris Complete myocardial revascularization with bilateral internal thoracic artery T graft Ann. Thorac. Surg., February 1, 2000; 69(2): 498 - 500. [Abstract] [Full Text] [PDF]

				A. M. Calafiore, G. Vitolla, A. L. Iaco, C. Fino, G. Di Giammarco, F. Marchesani, G. Teodori, G. D'Addario, and V. Mazzei Bilateral internal mammary artery grafting: midterm results of pedicled versus skeletonized conduits Ann. Thorac. Surg., June 1, 1999; 67(6): 1637 - 1642. [Abstract] [Full Text] [PDF]

				S. Noda and H. B. Barner Arterial conduits Ann. Thorac. Surg., January 1, 1999; 67(1): 285 - 286. [Full Text] [PDF]

				A. W. Pick, T. A. Orszulak, B. J. Anderson, and H. V. Schaff Single Versus Bilateral Internal Mammary Artery Grafts: 10-Year Outcome Analysis Ann. Thorac. Surg., September 1, 1997; 64(3): 599 - 605. [Abstract] [Full Text]

				S. E. Schmidt, J. W. Jones, J. I. Thornby, C. C. Miller III, and A. C. Beall Jr Improved Survival With Multiple Left-Sided Bilateral Internal Thoracic Artery Grafts Ann. Thorac. Surg., July 1, 1997; 64(1): 9 - 14. [Abstract] [Full Text]

				T. Carrel, P. Horber, and M. I. Turina Operation for Two-Vessel Coronary Artery Disease: Midterm Results of Bilateral ITA Grafting Versus Unilateral ITA and Saphenous Vein Grafting Ann. Thorac. Surg., November 1, 1996; 62(5): 1289 - 1294. [Abstract] [Full Text]

				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]