Perioperative and clinical-angiographic late outcome of total arterial myocardial revascularization according to different composite original graft techniques.

摘要: Total arterial myocardial revascularization (TAMR) is advisable because of the excellent long-term patency conduits. We present early and midterm outcomes five different surgical configurations for TAMR. Between January 1998 May 2004, 112 patients (aged 56.5 ± 4.5 years, 20% female) with three-vessel disease underwent The internal mammary arteries (IMAs) were harvested in a sketelonized fashion. techniques TAMR consisted Y or T composite grafts (n = 88, 78%) constructed between situ right IMA (RIMA) free left (LIMA) graft 58) radial artery 30) (RA) three configurations. other T- inverted T-graft 24, 22%) RA conduit LIMA two mean follow-up time was 40 23 months. Postoperative angiographic control performed 76/111 (70%) patients. Overall, 472 anastomoses (average 4.2 per patient) performed. One (0.9%) patient, undergoing technique, died on postoperative day 2. Another patient (0.9%), λ-graft technique using both IMAs RA, suffered new infarction probably due to vasospasm. week after surgery, transthoracic echocardiographic Doppler adenosine provocative test, coronary flow reserve (CFR) at RIMA main stems 2 0.4 2.4 0.3, respectively. At 12-month follow-up, CFRs significantly higher than values 1 surgery within same group; LIMACFR (1 week) 0.3 (12 months) vs 04 week), P 0.002; RIMACFR 2.58 0.001. CFR stem all measurements group stem, but not significantly. In one IMAs, found have string sign. angiography 50 showed that rate 100%, 97.3%, 96.7%. Angiography 3-year 76 documented rates (97.4%), (95%), (87%). Survival 7 years 92.5%, event-free survival 89.3%, freedom from angina 94%. safe effective. use provides clinical results, low recurrence late cardiac events. These allow complete revascularization.