Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomas

Abstract

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomasCABG late angiographic grafting patency analysis in patients with recurrent symptoms Abstract Objective: Left internal thoracic artery (LITA) grafting has become essential in coronary artery bypass graft procedure (CABG). In order to optimize the use of LITA or other grats, sequential anastomosis has been used. There is no consensus on equivalence between isolated versus sequential grafts. The aim of this study is to compare isolated versus sequential grafts.Methods: From a retrospective patency analysis of the grafts used in 88 symptomatic patients who underwent CABG procedure in our Service was performed through cinecoronariography. Statistical analysis was performed through Student's t test. Each distal anastomosis was considered an independent graft.Results: The mean postoperative period was of 53 + 138 months and mean age was 64 + 11 years. LITA isolated grafts presented patency rate significantly higher than the sequential grafts, respectively 92% (46/50) and 77% (30/39) P = 0.02. However, in injured coronary arteries of > 70%, isolated LITA patency rate was similar to sequential grafts, (95%; 37/39) and (93%; 26/28) respectively; P = 0.37. Mean radial artery patency rate was similar to isolated 71% (5/7) and sequential 90% (19/21) grafts; P = 0. Saphenous veinThis study was carried out at the Paulo Sacramento Hospital. patency rates were similar for isolated 72% (31/43) and sequential 81% (73/90) grafts; P = 0.12. There was no difference between radial artery and saphenous vein patency rates.Conclusion: In symptomatic patients, isolated LITA patency is superior than sequential LITA. However, in coronary injuries of > 70%, the isolated and sequential patency rates are similar. Sequential grafts from radial artery and saphenous vein are similar to their respective isolated grafts. Descriptors: Radial artery. Mammary arteries. Saphenous vein. Coronary disease/surgery. Myocardial revascularization. Resumo Objetivo: A Artéria Torácica Interna Esquerda (ATIE) é o padrão ouro como enxerto na revascularização miocárdica (RM). Para otimizar seu uso, e de outros enxertos, têm sido usadas anastomoses sequenciais. Não há consenso da equivalência dos resultados entre enxertos isolados e sequenciais. O objetivo é comparar a perviabilidade dos enxertos isolados versus sequenciais. 139ROCHA E SILVA, R ET AL -CABG late angiographic grafting patency analysis in patients with recurrent symptoms Bras Cir Cardiovasc 2009; 24(2): 138-142 Rev

The Composite Aortic Wall Graft Technique: An Option for a Short Coronary Artery Bypass Graft

“…Several studies have demonstrated the benefits of complete arterial revascularization. 7 – 11 This technique can add an additional 4 cm to a radial artery graft, which in turn allows it to reach the circumflex and the right coronary regions through sequential anastomosis. In addition, this should not increase the chances of morbidity because the aortic manipulation consists of a couple of linear sutures.…”