Sequential Use of Internal Thoracic Artery in Myocardial Revascularization: Mid- to Long- term Results of 430 Patients

There is stili controversy about early and Iate results of sequenital use of internal thoracic artery (ITA) in coronary artery bypass (CAB) operations. In thi s study, we report on a series of 430 consecutive patients who had undergone CAB operations between 1986 and 1998, with the use of at least one sequential IT A graft. The patients, 379 men and 51 women had a mean age of 56,4 years (range 29 to 80 years). Both ITA grafts were usedin 227 (52,8%). A total of 1744 (mean 4,05 per patient) distal coronary anastomoses were performed. 1172 of which (mean 2,72) were arterial and 980 of which (mean 2,28) were sequential ITA anastomoses. Thirty-day mortality was ı ,8% (n=8 patients). Perioperative myocardial infaretion occurred in 12 patients (2,8%) and 5 of them (1,2%) were confined to the sequential IT A grafted area. Follow-up ranged from ı month to 13 years (mean 63±37 ,7 months) for 372 patients (86,5%). Nine patients died during follow-up period. According to Kaplan-Me ier method, 5 and 10 year survival rate was 95,6% and 93,4% respectively. Coronary angiography was performed in 64 patients (17,2%) after a mean of 33 months ( ıO day to ı o year). In 31 of these patients angiography was performed due to returo of symptoms. Overall patency ra te of sequential IT A anastomoses was 9 ı , 7 % (1 11/1 21 ). Two patients underwent repeat CAB operations Sequential use of IT A grafts w as not associated w ith the increased perioperative mortality and morbidity and has the potential to improve the long-term results of CAB surgery because of excellent patency ra tes of sequential IT A anastomoses.