Comparative analysis of the patency of the internal thoracic artery in
the CABG of left anterior descending artery: 6-month postoperative coronary CT
angiography evaluation |
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| Authors: | Maurilio Onofre Deininger Luiz Felipe Pinho Moreira Luiz Alberto Oliveira Dallan Orlando Gomes de Oliveira Daniel Marcelo Silva Magalh?es José Reinaldo de Moura Coelho Eugênia di Giuseppe Deininger Norland de Souza Lopes Ricardo Wanderley Queiroga Elizabeth Ferreira Belmont |
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| Institution: | 1. Hospital Unimed João Pessoa /Hospital Memorial São Francisco, João Pessoa, PB, Brazil;2. Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil |
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| Abstract: | Objective To assess the patency of the pedicled right internal thoracic artery with an
anteroaortic course and compare it to the patency of the left internal thoracic
artery , in anastomosis to the left anterior descending artery in coronary artery
bypass grafting by using coronary CT angiography at 6 months postoperatively. Methods Between December 2008 and December 2011, 100 patients were selected to undergo a
prospective coronary artery bypass grafting procedure without cardiopulmonary
bypass. The patients were randomly divided by a computer-generated list into
Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used
was known at the beginning of the surgery. In G-1, coronary artery bypass grafting
was performed using the left internal thoracic artery for the left anterior
descending and the free right internal thoracic artery for the circumflex, and in
G-2, coronary artery bypass grafting was performed using the right internal
thoracic artery pedicled to the left anterior descending and the left internal
thoracic artery pedicled to the circumflex territory. Results The groups were similar with regard to the preoperative clinical data. A male
predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five
patients migrated from G-1 to G-2 because of atheromatous disease in the ascending
aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20
(SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that
all ITAs, right or left, used in situ for the left anterior descending were
patent. There were no deaths in either group. Conclusion Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic
right internal thoracic artery to the left anterior descending artery has an
outcome similar to that obtained using the left internal thoracic artery for the
same coronary site. |
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| Keywords: | Mammary Arteries Myocardial Revascularization Cardiopulmonary Bypass Coronary Artery Disease |
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