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Comparative Analysis Following Implementation of Two Types of Y-Composite Multiarterial Revascularization Strategies at a Single Academic Institution.
Gharibeh, Lara; Hosoyama, Katsuhiro; Glineur, David; Shaw, Richard E; Lapierre, Harry; Ruel, Marc; Grau, Juan B.
Afiliación
  • Gharibeh L; Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.
  • Hosoyama K; Department of Biochemistry, Microbiology and Immunology University of Ottawa Ottawa Ontario Canada.
  • Glineur D; Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.
  • Shaw RE; Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.
  • Lapierre H; Division of Cardiothoracic Surgery The Valley Hospital Ridgewood NJ.
  • Ruel M; Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.
  • Grau JB; Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.
J Am Heart Assoc ; 10(10): e020002, 2021 05 18.
Article en En | MEDLINE | ID: mdl-33938227
ABSTRACT
Background We compared early outcomes, at a single academic institution, of implementing full coronary revascularization in coronary artery bypass grafting using multiarterial Y-composite grafts with multiple sequential anastomoses. Methods and Results Clinical records of 425 consecutive patients who underwent coronary artery bypass grafting using Y-grafting with left internal mammary artery and radial artery (Y-RA group) or right internal mammary artery (Y-RIMA group) from 2015 to 2019, were reviewed. These were compared with the institutional experience of isolated coronary artery bypass grafting cases (in situ on pump/off pump) for the same period of time. When comparing the 4 groups, the Y-RIMA/RA groups revealed a higher number of distal anastomosis than the in situ on- or off-pump groups. When the number of distal arterial anastomosis was analyzed, there was a superiority of using the Y-configuration compared with the in situ approach. Moreover, there were no significant differences among groups for mortality and/or major adverse cardiac and cerebrovascular events in hospital or at 30-day follow-up. A subanalysis comparing the Y-RIMA group with the Y-RA group showed that complementary grafts to the Y-construct were required to accomplish full revascularization more frequently in the Y-RIMA group. Full-arterial revascularization was achieved in 92.2% of the Y-RA group and 72.0% of the Y-RIMA group (P<0.001). In 82.8% of the Y-RA group and 30.8% of the Y-RIMA group, revascularization was completed as an anaortic procedure (P<0.001). Conclusions The 2 types of arterial Y-composite grafting were able to be introduced in the routine practice of our institution showing comparable results to the established institutional practice. This procedure allowed for more arterial distal anastomosis to be performed safely without compromising outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Arteria Radial / Guías de Práctica Clínica como Asunto / Academias e Institutos / Arterias Mamarias Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2021 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Arteria Radial / Guías de Práctica Clínica como Asunto / Academias e Institutos / Arterias Mamarias Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2021 Tipo del documento: Article