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

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Paolini, G. Articles by Grossi, A. Search for Related Content PubMed PubMed Citation Articles by Paolini, G. Articles by Grossi, A.

European Journal of Cardio-Thoracic Surgery, Vol 7, 91-95, Copyright © 1993 by European Association for Cardio-thoracic Surgery

ARTICLES

Total arterial myocardial revascularization

G Paolini, MA Mariani, S Benussi, M Zuccari, G Di Credico, C Gallorini and A Grossi
Institute for Cardiovascular and Respiratory Diseases, University of Milan, Scientific Institute H. San Raffaele, Italy.

The superiority of the internal thoracic artery (ITA) compared with venous conduits in terms of late graft patency is nowadays well documented. The inferior epigastric artery (IEA) was recently proposed as an alternative conduit for coronary artery surgery with good early clinical and angiographic results. To improve the benefits from myocardial revascularization, we expanded the use of these arterial conduits. From June 1988 to December 1991, 615 patients underwent coronary surgery in our institute. In 138 of them (22.4%) we performed total arterial myocardial revascularization placing 2 or more coronary anastomoses. An average of 2.37 anastomoses per patient were placed with the maximum number of 6 in one case. Only one patient died of cardiac related causes (0.72%). Perioperative morbidity included myocardial infarction and sternal dehiscence in 5 patients each (3.6%). No stroke or reoperation for bleeding occurred. No rectus muscle necrosis was recorded. Accurate preoperative planning of graft placement allows for the performance of as many as 6 distal anastomoses using bilateral ITA and single IEA grafts only, thus completely revascularizing most of the hearts with three-vessel disease. In our series this procedure was not reflected in an increase in the perioperative morbidity. We choose an elective total arterial revascularization in younger (under 65 years) patients who, while showing a lower incidence of complications in our study, are likely to derive the highest benefits from the good durability of ITA and hopefully IEA grafts.

This article has been cited by other articles:

				F. Formica, O. Ferro, M. Brustia, F. Corti, L. Colagrande, E. Bosisio, and G. Paolini Effects of Papaverine and Glycerilnitrate-Verapamil Solution as Topical and Intraluminal Vasodilators for Internal Thoracic Artery Ann. Thorac. Surg., January 1, 2006; 81(1): 120 - 124. [Abstract] [Full Text] [PDF]

				N. T. Kouchoukos, B. Barzilai, V. G. Davila-Roman, M. D. Hariawala, M. A. Goldsborough, O. A. Selnes, G. M. McKhann, G. W. Roach, and D. T. Mangano Adverse Cerebral Outcomes after Coronary Bypass Surgery N. Engl. J. Med., May 29, 1997; 336(22): 1605 - 1607. [Full Text]

				G.-W. He, T. E. Acuff, W. H. Ryan, C.-Q. Yang, and M. J. Mack Functional comparison between the human inferior epigastric artery and internal mammary arterySimilarities and differences J. Thorac. Cardiovasc. Surg., January 1, 1995; 109(1): 13 - 20. [Abstract] [Full Text]