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Ann Thorac Surg 2007;83:1666-1671
© 2007 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Long-Term Results of Bilateral Internal Thoracic Artery Grafting in Dialysis Patients

^a Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyusyu City, Fukuoka, Japan
^b Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Morioka, Iwate, Japan

Accepted for publication December 6, 2006.

^_* Address correspondence to Dr Okabayashi, Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Chuodori 1-2-1, Morioka, Iwate 020-8505, Japan (Email: cardiovascsurg{at}siren.ocn.ne.jp).

Background: We evaluated the perioperative and long-term results of bilateral internal thoracic artery grafting in dialysis patients.

Methods: One hundred one consecutive patients on chronic dialysis who underwent isolated coronary artery bypass grafting were retrospectively compared according to the surgical technique, bilateral internal thoracic artery (BITA) grafting (n = 76) or single internal thoracic artery (SITA) grafting (n = 25).

Results: Hospital mortality was 5.3% in the BITA group and 8.0% in the SITA group (p = not significant). The incidence of mediastinitis was not different (7.9% in the BITA group and 8.0% in the SITA group). The median duration of follow-up was 3.1 years (range, 0.1 to 10.9). Survival and freedom from cardiac mortality were not different between the two groups, but the BITA group had a trend toward better results. Freedom from cardiac events (including cardiac-related death, myocardial infarction, pecutaneous coronary intervention, redo coronary artery bypass grafting, and congestive heart failure) was superior in the BITA group (p = 0.03). Calcification of the ascending aorta, peripheral vascular disease, insulin-dependent diabetes mellitis, and age were the independent risk factors of late death.

Conclusions: Perioperative results of BITA grafting in dialysis patients were not different from the results of SITA grafting. However, the long-term results of BITA grafting in dialysis patients were better than the results of SITA grafting. Overall, our results support the continued use of BITA grafting in dialysis patients.

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				F. A. Baciewicz Jr Selection of Dialysis Patients for Bilateral Internal Thoracic Artery Grafts Ann. Thorac. Surg., November 1, 2007; 84(5): 1797 - 1797. [Full Text] [PDF]