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): Rephael Mohr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pevni, D. Articles by Mohr, R. Search for Related Content PubMed PubMed Citation Articles by Pevni, D. Articles by Mohr, R. Related Collections Coronary disease

Eur J Cardiothorac Surg 2001;20:299-304
© 2001 Elsevier Science NL

Composite arterial grafting with double skeletonized internal thoracic arteries

Department of Cardiac and Thoracic Surgery, The Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel

Received 14 November 2000; received in revised form 26 April 2001; accepted 30 May 2001.

Corresponding author. Tel.: +972-3-6923322; fax: +972-3-6274439
e-mail: pevni{at}tasmc.health.gov.il

Objectives: Composite arterial grafting is a surgical technique for arterial myocardial revascularization, in which free arterial conduits are proximally anastomosed end-to-side to an intact internal thoracic artery (ITA). This report describes technical aspects and results of composite grafting using bilateral skeletonized ITAs. Methods: From April 1996 to February 1999, 1057 patients underwent coronary artery bypass grafting (CABG) using bilateral skeletonized internal thoracic arteries. In 600 of them (57%), composite arterial grafting was performed. There were 452 men and 148 women. The mean age was 69±7 years. Two-hundred and six patients (34%) were diabetics, 84 (14%) had severe left ventricular dysfunction (ejection fraction of <35%), and 26 (4.3%) underwent emergency operations. In 574 patients, the right ITA was used as a free graft connected to the in-situ left ITA. In 26, the free left ITA was attached to the in-situ right ITA, and in 38, mini-composite grafts (free distal left ITA on the left ITA, or free distal right ITA on the right ITA) were constructed. The average number of grafts was 3.0/patient (range, 2–6). Results: The operative mortality was 2.8% (n=17), and there were ten (1.7%), deep sternal wound infections. The mean follow-up was 25 months (range, 14–36 months). The 3-year survival was 92.5%. Ninety-seven percent of the surviving patients were angina-free. Conclusions: We currently perform this surgery routinely in most patients referred for CABG, and regard bilateral skeletonized internal thoracic arteries as the most appropriate arterial conduits for the composite technique.

Key Words: Internal thoracic artery • Composite graft • Technical aspects

This article has been cited by other articles:

				G. Gatti, C. Bentini, G. Maffei, F. Ferrari, M. Dondi, P. Pacilli, and P. Pugliese Noninvasive Dynamic Assessment With Transthoracic Echocardiography of a Composite Arterial Y-Graft Achieving Complete Myocardial Revascularization Ann. Thorac. Surg., April 1, 2005; 79(4): 1217 - 1224. [Abstract] [Full Text] [PDF]

				I. Herz, Y. Moshkovitz, A. Hendler, S. Z. Adam, G. Uretzky, Y. Ben-Gal, and R. Mohr Revascularization of Left Anterior Descending Artery With Drug-Eluting Stents: Comparison With Off-Pump Surgery Ann. Thorac. Surg., January 1, 2005; 79(1): 88 - 92. [Abstract] [Full Text] [PDF]

				B. Markl, S. Raab, H. Arnholdt, and C. Vicol Morphological and histopathological comparison of left and right internal thoracic artery with implications on their use for coronary surgery Interactive CardioVascular and Thoracic Surgery, March 1, 2003; 2(1): 73 - 76. [Abstract] [Full Text] [PDF]

				O. Lev-Ran, R. Mohr, G. Uretzky, D. Pevni, C. Locker, Y. Paz, and I. Shapira Graft of choice to right coronary system in left-sided bilateral internal thoracic artery grafting Ann. Thorac. Surg., January 1, 2003; 75(1): 88 - 92. [Abstract] [Full Text] [PDF]

				G.G. Santos, N.A.G. Stolf, L.F.P. Moreira, V.L.S. Haddad, R.M.C. Simoes, S.R.V. Carvalho, A.A. Salgado, and S.F. Avelar Jr. Randomized comparative study of radial artery and right gastroepiploic artery in composite arterial graft for CABG Eur. J. Cardiothorac. Surg., June 1, 2002; 21(6): 1009 - 1014. [Abstract] [Full Text] [PDF]

				Y. Takami and H. Ina Effects of skeletonization on intraoperative flow and anastomosis diameter of internal thoracic arteries in coronary artery bypass grafting Ann. Thorac. Surg., May 1, 2002; 73(5): 1441 - 1445. [Abstract] [Full Text] [PDF]