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J Cardiovasc Surg (Torino) ; 54(4): 531-6, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24013541

RESUMEN

AIM: Composite arterial grafts using a T configuration from the left internal mammary artery (LIMA) are commonly used for coronary artery surgery. Little data exist regarding the use of saphenous vein (SV) in composite grafts from the LIMA. This study aimed to determine whether LIMA patency was reduced by the attachment of a SV T graft. METHODS: Patients (N.=166) who underwent coronary bypass surgery using the LIMA for SV graft inflow were identified from a database. Post discharge angiography was performed for investigation of symptoms or evidence of myocardial ischemia. Follow-up identified episodes of angiography, re-intervention and death. RESULTS: Complete follow-up was obtained in 165 patients, mean 6 years (0-16 years). The mean patient age was 70 years and 43 patients underwent concomitant procedures. In 25 patients who underwent post discharge angiography, the LIMA and T anastomoses were widely patent in 14 patients. The SV graft was occluded at the T anastomosis in 8 patients and the distal limb of the LIMA was occluded in 2 patients. In no patients were the vein and LIMA both occluded. CONCLUSION: The use of the LIMA for SV graft inflow does not appear to compromise the LIMA graft even when SV graft occlusion occurs.


Asunto(s)
Puente de Arteria Coronaria/métodos , Circulación Coronaria , Vasos Coronarios/cirugía , Vena Safena/trasplante , Grado de Desobstrucción Vascular , Anciano , Angiografía Coronaria , Puente de Arteria Coronaria/efectos adversos , Puente de Arteria Coronaria/mortalidad , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/fisiopatología , Femenino , Oclusión de Injerto Vascular/etiología , Oclusión de Injerto Vascular/fisiopatología , Humanos , Estimación de Kaplan-Meier , Masculino , Valor Predictivo de las Pruebas , Factores de Riesgo , Vena Safena/diagnóstico por imagen , Vena Safena/fisiopatología , Factores de Tiempo , Resultado del Tratamiento
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