Compare the Early Result of Total Arterial Revascularization with Traditional Coronary Artery Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Keming , WANG Wei , GAO Huawei

Department of Cardiac Surgery Fu Wai Hospital, Chinese Academy of Medical Sciences &;
Peking Union Medical College, Beijing 100037, P.R. China. E-mail: ykmzmc3227@hotmail.com;

Corresponding author：

Keywords：

Total arterial revascularization, Coronary artery bypass grafting, Off-pump coronary artery bypass grafting

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Objective To assess the use of arterial revascularization and to compare the early outcomes with traditional coronary artery bypass grafting (CABG). Methods From January 1999 to January 2005, 123 patients (114 male, 9 females; age 52.2±10.1 years) underwent coronary artery surgery alone with disease of more than one coronary artery were considered for complete arterial revascularization (artery revascularization group). Internal mammary artery and radial artery was considered for artery grafts. At same period 115 patients (102 males, 13 females; age 60.3±9.1 years) underwent traditional revascularization using left internal mammary artery and veins (traditional group). The purpose was to compare the operative results between two groups. Results The patients in artery revascularization group were younger than that in traditional group, but there were more patients with three vessels disease in traditional group(54.5% vs. 86.1%, P=0.001). Off-pump CABG was choosed for more patients in artery revascularization group (26.0% vs. 57.4%, P=0.001). Patients in this group need more operative time if on-pump technique was used. The number of grafts were less in this group (2.6±0.7 vs. 3.4±0.9, P=0.001).There was no significant difference in hospital mortality and morbidity between two groups. Conclusion Proper patients using artery grafts appear to be safe in terms of in hospital mortality and morbidity.

Citation： YANG Keming,WANG Wei,GAO Huawei,ZHANG Peng. Compare the Early Result of Total Arterial Revascularization with Traditional Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(6): 411-. doi: Copy

1.	Bourassa MG. Fate of venous grafts: The past, the present and the future. J Am Coll Cardiol, 1991, 17(5):1081-1083.
2.	Barner HB, Swartz MT, Mudd JG, et al. Late patency of the internal mammary artery as a coronary bypass conduit. Ann Thorac Surg, 1982, 34(4): 408-412.
3.	Fitzgibbon GM, Kafka HP, Leach AJ, et al.Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3): 616-626.
4.	El Oakley RM, Al Habib HF. Total arterial coronary revascularization using arterial bypass circle with multiple inflows. Ann Thorac Surg, 2007, 83(5): 1911-1912.
5.	Ferrari ER, Von Segesser LK. Arterial grafting for myocardialrevascul arization: how better is it Curr Opin Cardiol, 2006, 21(6): 584-588.
6.	Pevni D, Mohr R, Lev-Ran O, et al. Technical aspects of composite arterial grafting with double skeletonized internal thoracic arteries. Chest, 2003, 123(5): 1348 -1354.
7.	Baskett RJ, Cafferty FH, Powell SJ, et al. Total arterial revascularization is safe: Multicenter ten-year analysis of 71,470 coronary procedures. Ann Thorac Surg, 2006, 81(4): 1243-1248.
8.	Barner HB. Use of the internal thoracic artery: simple, complex, or with a backup Ann Thorac Surg, 1994, 57(1):8-9.
9.	Légaré JF, Buth KJ, Sullivan JA, et al. Composite arterial grafts versus conventional grafting for coronary artery bypass grafting. J Thorac Cardiovasc Surg, 2004, 127(1): 160-166.
10.	Acar C, Jebara VA, Portoghese M, et al. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg, 1992, 54(4):652-669.
11.	Bhan A, Gupta V, Choudhary SK, et al. Radial artery in CABG: Could the early results be comparable to internal mammary artery graft Ann Thorac Surg, 1999, 67(6): 1631- 1636.
12.	Caputo M, Reeves B, Marchetto G, et al. Radial versus right internal thoracic artery as a second arterial conduit for coronary surgery: early and midterm outcomes. J Thorac Cardiovasc Surg, 2003, 126(1): 39-47.
13.	Calafiore AM, Di Giammarco G, Luciani N, et al. Composite arterial conduits for a wider arterial myocardial revascularization. Ann Thorac Surg , 1994, 58(1):185-190.
14.	Gaudino M, Di Mauro M, Iac′o AL, et al. Immediate flow reserve of Y thoracic artery grafts: an intraoperative flowmetric study. J Thorac Cardiovasc Surg, 2003, 126(4):1076 -1079.

1. 　Bourassa MG. Fate of venous grafts: The past, the present and the future. J Am Coll Cardiol, 1991, 17(5):1081-1083.
2. 　Barner HB, Swartz MT, Mudd JG, et al. Late patency of the internal mammary artery as a coronary bypass conduit. Ann Thorac Surg, 1982, 34(4): 408-412.
3. 　Fitzgibbon GM, Kafka HP, Leach AJ, et al.Coronary bypass graft fate and patient outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol, 1996, 28(3): 616-626.
4. 　El Oakley RM, Al Habib HF. Total arterial coronary revascularization using arterial bypass circle with multiple inflows. Ann Thorac Surg, 2007, 83(5): 1911-1912.
5. 　Ferrari ER, Von Segesser LK. Arterial grafting for myocardialrevascul arization: how better is it Curr Opin Cardiol, 2006, 21(6): 584-588.
6. 　Pevni D, Mohr R, Lev-Ran O, et al. Technical aspects of composite arterial grafting with double skeletonized internal thoracic arteries. Chest, 2003, 123(5): 1348 -1354.
7. 　Baskett RJ, Cafferty FH, Powell SJ, et al. Total arterial revascularization is safe: Multicenter ten-year analysis of 71,470 coronary procedures. Ann Thorac Surg, 2006, 81(4): 1243-1248.
8. 　Barner HB. Use of the internal thoracic artery: simple, complex, or with a backup Ann Thorac Surg, 1994, 57(1):8-9.
9. 　Légaré JF, Buth KJ, Sullivan JA, et al. Composite arterial grafts versus conventional grafting for coronary artery bypass grafting. J Thorac Cardiovasc Surg, 2004, 127(1): 160-166.
10. 　Acar C, Jebara VA, Portoghese M, et al. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg, 1992, 54(4):652-669.
11. 　Bhan A, Gupta V, Choudhary SK, et al. Radial artery in CABG: Could the early results be comparable to internal mammary artery graft Ann Thorac Surg, 1999, 67(6): 1631- 1636.
12. 　Caputo M, Reeves B, Marchetto G, et al. Radial versus right internal thoracic artery as a second arterial conduit for coronary surgery: early and midterm outcomes. J Thorac Cardiovasc Surg, 2003, 126(1): 39-47.
13. 　Calafiore AM, Di Giammarco G, Luciani N, et al. Composite arterial conduits for a wider arterial myocardial revascularization. Ann Thorac Surg , 1994, 58(1):185-190.
14. 　Gaudino M, Di Mauro M, Iac′o AL, et al. Immediate flow reserve of Y thoracic artery grafts: an intraoperative flowmetric study. J Thorac Cardiovasc Surg, 2003, 126(4):1076 -1079.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Compare the Early Result of Total Arterial Revascularization with Traditional Coronary Artery Bypass Grafting

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