Lessons learned from the use of 1,977 in-situ bilateral internal mammary arteries: a retrospective study

Journal of Cardiothoracic Surgery

Dimitri Kalavrouziotis¹  Eric Charbonneau²  Daniel Doyle²  Richard Baillot²  Eric Dumont²  Pierre Voisine²  Francois Dagenais²  Siamak Mohammadi² 

[1] Attending surgeon, Division of Cardiac Surgery, 2725 chemin Sainte-Foy, Quebec City G1V 4G5, QC, Canada;Division of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec City, QC, Canada

关键词: Outcomes;    Arterial grafts;    Coronary artery bypass graft surgery;   

Others  :  1151750
DOI  :  10.1186/s13019-014-0158-9

 received in 2014-05-20, accepted in 2014-09-02,  发布年份 2014

【 摘 要 】

Background

We sought to determine the early and long-term results of in-situ bilateral internal mammary artery (BIMA) grafting in patients undergoing coronary artery bypass graft surgery (CABG).

Methods

Between 1992 and 2011, 16,364 patients underwent primary isolated CABG involving at least one in-situ IMA at our institution. Among these, 1,977 patients underwent in-situ BIMA grafting: the right IMA was used to revascularize the right coronary artery system in 1,279, the circumflex system in 454 patients, and the left anterior descending (LAD) in 244. Logistic and Cox regression analyses were used to predict in-hospital mortality and cumulative late death.

Results

Late survival among BIMA patients was negatively and independently influenced by chronic obstructive pulmonary disease (hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.6-3.4, p?=?0.0005), age (HR 1.2, 95% CI 1.1-1.3, p?p?p?=?0.80).

Conclusions

Female gender, non-insulin dependent diabetes, and the site of second IMA anastomosis did not influence early and long-term outcomes in patients undergoing CABG with in-situ BIMA grafting. The right and left IMAs are equally effective conduits for the LAD. However, advanced age, chronic obstructive pulmonary disease, and insulin-treated diabetes mellitus have a negative impact on late survival among patients with BIMA grafts.

【 授权许可】

   
2014 Mohammadi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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