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Ann Thorac Surg 1996;62:1294
© 1996 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1289.

DR NOEL L. MILLS (New Orleans, LA): I thank Doctor Carrel and co-authors for the opportunity to review their manuscript. They have compared retrospectively and in a nonrandomized fashion two groups of patients with one ITA versus two ITA grafts. They are to be applauded for their effort in pursuing the question: "Are two IMA grafts better than one?" However, I do not think this study offers any final answer, and here is why.

The first reason is the time frame-When do SVGs fail? At 8 years, which is the maximum follow-up time in this study, the SVGs are just beginning to enter the high-attrition zone. Only after 10 years or more would one expect the ITAs to show the effects of their resistance to atherosclerosis compared with an atherosclerosis-prone SVG.

The second concerns the anatomy of the coronary arteries. Ninety-five percent and more of the LADs are a single sizable vessel. Not so with the RCA system, and I use the word systemas . . . [Full Text of this Article]

Related Article

Operation for Two-Vessel Coronary Artery Disease: Midterm Results of Bilateral ITA Grafting Versus Unilateral ITA and Saphenous Vein Grafting

Thierry Carrel, Patrick Horber, and Marko I. Turina
Ann. Thorac. Surg. 1996 62: 1289-1294. [Abstract] [Full Text]