Comparing the patency of the left internal mammary in single, sequential, and Y grafts.
J Thorac Cardiovasc Surg
; 167(1): 176-182, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-35317917
ABSTRACT
BACKGROUND:
To maximize arterial grafts, left internal mammary (LIMA) sequential and Y grafts are used. The aim is to compare the angiographic patency of the LIMA in these configurations.METHODS:
Between 2002 and 2020, angiography was performed on 1000 patients who either had a single (570), sequential (100), or LIMA y (129) graft. The LIMA was divided into segments (S); S1 LIMA inflow to the first anastomosis, S2 terminal portion of the LIMA to left anterior descending (LAD), and S3; the y-limb anastomosis to a coronary. S1 and S2 patency analysis was carried out with logistic regression.RESULTS:
Failure of the S1 and S2 was 3.7% single, 9% sequential, and 6.2 Y graft (P = .049). Segment 1 failed in 3.7% in single, 5% in sequential, and 0.8% in Y grafts (P = .049). Segment 3 failure was 10.3%. Regression revealed female sex and sequential grafts were associated with decreased S1 and S2 patency.CONCLUSIONS:
Single grafts have the best patency. Failure in sequential grafts leads to increased occlusion of the LIMA inflow, whereas Y-graft failure tends to occlude the y limb. When arterial conduit is sparse, a Y graft should be considered.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artéria Torácica Interna
Limite:
Female
/
Humans
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2024
Tipo de documento:
Article