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

This Article Full Text Full Text (PDF) 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): Lester R. Sauvage David M. Gartman Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sauvage, L. R. Articles by Fisher, L. D. Search for Related Content PubMed PubMed Citation Articles by Sauvage, L. R. Articles by Fisher, L. D. Related Collections Coronary disease

Ann Thorac Surg 2003;75:501-504
© 2003 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Internal thoracic artery grafts for the entire heart at a mean of 12 years

^a The Hope Heart Institute, University of Washington, Seattle, Washington, USA
^b Providence Seattle Medical Center, University of Washington, Seattle, Washington, USA
^c Swedish Medical Center, University of Washington, Seattle, Washington, USA
^d Department of Surgery, University of Washington, Seattle, Washington, USA
^e Department of Medicine, University of Washington, Seattle, Washington, USA
^f Department of Biostatistics, University of Washington, Seattle, Washington, USA

Accepted for publication August 21, 2002.

* Address reprint requests to Dr Sauvage, The Hope Heart Institute, 528 18th Ave, Seattle WA 98122, USA.
e-mail: lsauvage{at}hopeheart.org

BACKGROUND: There is consensus today that the long-term results of bypassing the left anterior descending artery with an internal thoracic artery (ITA) graft are superior to those of a saphenous vein graft. Our hypothesis for this study was that three-vessel revascularization with only ITA grafts would also give excellent results.

METHODS: Using our previously described techniques to enhance the length of ITA grafts by skeletonization and high mediastinal mobilization, we were able to perform tension-free, three-vessel revascularization using only ITA grafts in 125 (83%) of a consecutive series of 150 patients with three-vessel occlusive coronary disease. We followed 100% of these 125 exclusive ITA graft patients (average of 3.9 anastomoses per patient) to their time of death (59; 47.2%) or current living status (66; 52.8%).

RESULTS: Combined intraoperative graft flows averaged 225 mL/min. Of the 125 patients in this study (average age, 63.5 years), 121 (96.8%) lived beyond 40 days. Of these 121 patients, 55 (45%) died at a mean of 7 years postoperatively and 66 (55%) are still living at a mean of 12.1 years. Of these 121 patients, 112 (93%) had angina at baseline. Of these 112, 92 (85%) were angina free at a mean of 9.1 years postoperatively. Freedom from infarction was 100% at 5 years and 97% at 10 years. Freedom from reintervention was 90% at a mean of 9.8 years.

CONCLUSIONS: Use of ITA grafts for three-vessel coronary revascularization provides excellent results and is both practical and appropriate for many patients.

This article has been cited by other articles:

				G. Gatti, A. Pappalardo, L. Gon, and B. Zingone Protecting the Crossover Right Internal Thoracic Artery Bypass Graft With a Pedicled Thymus Flap Ann. Thorac. Surg., November 1, 2006; 82(5): 1919 - 1921. [Abstract] [Full Text] [PDF]

				J. Zeitani, A. P. de Peppo, R. De Paulis, P. Nardi, A. Scafuri, S. Nardella, and L. Chiariello Benefit of Partial Right-Bilateral Internal Thoracic Artery Harvesting in Patients at Risk of Sternal Wound Complications Ann. Thorac. Surg., January 1, 2006; 81(1): 139 - 143. [Abstract] [Full Text] [PDF]

				T. Athanasiou, M.-C. Crossman, G. Asimakopoulos, A. Cherian, A. Weerasinghe, B. Glenville, and R. Casula Should the internal thoracic artery be skeletonized? Ann. Thorac. Surg., June 1, 2004; 77(6): 2238 - 2246. [Abstract] [Full Text] [PDF]