The propriety of bilateral internal thoracic artery grafting in women

In our institusion, the exclusion criteria of the bilateral internal thoracic artery (BITA) grafting include age over 70 years old, obesity, severe diabetus, renal dysfunction and poor preoperative physical activity. The objective of this study is to evaluate propriety of the use of bilateral internal thoracic artery for coronary artery bypass grafting (CABG) in women. Clinical outcome of female patients who underwent BITA grafting (group B-F; n=50) was compared with that of female patients who underwent single internal thoracic artery grafting (group S; n=50). In addition, clinical outcome of the male patients who underwent BITA grafting (group B-M; n=50) was compared with that of group B-F. Between group B-F and S, the age, prevalence of obesity and that of renal dysfunction were significantly different, which was predictable because of the group selection according to the criteria. However, the prevalence of previous myocardial infarction and that of left ventricular dysfunction and the extent of coronary artery disease were not significantly different. Whereas, between group B-F and B-M, preoperative factors were not significantly different except the body size. Intraoperative technical factors, such no of grafts, aortic cross clamp time, cardiopulmonary bypass time, rate of complete revascularization, were not significantly different. In comparison of group B-F with group B-M, the site of anastomosis with arterial grafts were not significantly different. Patency rate of arterial and venous grafts two week after operation was not significantly different. Either postoperative complications, such as reoperation for bleeding, wound complication, low output symdrome, renal dysfunction etc, were not significantly different. One patient (2%) in group B-F and 1 patient (2%) in group B-M died in the hospital (p>0.05). In summary, BITA can be a viable conduit of choice for CABG in female patients as well as that in male patients. Criteria of the use of BITA is recommended to exclude preoperative risk factors abovementioned.