Bilateral mammary artery grafting: Avoidance of complications with extended use

Accola, Kevin D.; Jones, Ellis L.; Craver, Joseph M.; Weintraub, William S.; Guyton, Robert A.

doi:10.1016/0003-4975(93)90347-k

Cited by 36 publications

(10 citation statements)

References 27 publications

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“…Sternal infection is of most concern in patients after bilateral IMA harvest, especially diabetic nephropathy patients. Some researchers advise caution in extensive use of the bilateral IMA in diabetic patients (6,7). ESRD‐associated medical problems, such as decreased immune function, osteoporosis, and chronic anemia all adversely affect sternal wound healing.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

et al. 2002

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Patients with both end-stage renal disease and diabetes mellitus carry an increased risk of coronary atherosclerosis. This study was performed to evaluate the perioperative and remote outcome of diabetic nephropathy patients on hemodialysis undergoing coronary artery bypass grafting (CABG). We retrospectively analyzed the results of CABG performed between September 1, 1993 and August 31, 2001. Preoperative, perioperative, and follow-up data of patients with hemodialysis primarily due to diabetic nephropathy (Group D, n = 31, 22 males and 9 females with a mean age of 60.1 +/- 6.6) were collected and compared to patients with hemodialysis primarily due to nondiabetic nephropathy (group N, n = 21, 17 males and 4 females with a mean age of 60.9 +/- 11.2). Preoperative risk factors between the 2 groups were not significantly different. The mean number of distal anastomoses was 2.5 +/- 1.2 in Group D and 2.5 +/- 1.0 in Group N (p = not significant [NS]). All patients received at least 1 internal mammary artery graft. There was 1 in-hospital death in each group. Postoperative recovery, mortality, and morbidity were not significantly different between the two groups. At the mean follow-up of 2.7 years, the actuarial 3 year survival rate was 72.8% in Group D and 78.7% in Group N (p = NS). The actuarial 3 year cardiac event-free rate was 79.7% in Group D and 74.7% in Group N (p = NS). CABG for hemodialysis patients can be performed with acceptable risks. Diabetic nephropathy has no impact on early or remote patient outcomes among patients on hemodialysis.

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Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

et al. 2002

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“…More specifically, death, recurrent angina, new myocardial infarction, and coronary reintervention occurred more often in LIMA (49.4%) than BIMA (33.3%) patients ( p = 0.0004). Accola and colleagues 22 showed that in young patients, BIMA could be safely used without putting them at higher risk of perioperative morbidity or mortality.…”

Section: Single Vs Bilateral Internal Mammary Arteriesmentioning

confidence: 99%

Is there any further advantage of using more than one internal mammary artery? Literature review and analysis

Parissis

Soo

Al-Alao

2013

Asian Cardiovasc Thorac Ann

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The use of the internal mammary artery reduces the incidence of late adverse effects and improves survival after coronary artery bypass grafting. Therefore, internal mammary artery grafts ought to be used in all patients undergoing coronary artery bypass grafting (level II evidence), although in the UK, only 95% of the patients receive an internal mammary artery graft. This is due to factors such as poor left ventricular function, old age, previous radiation to the thoracic cavity, or emergency surgery. As there are biological similarities between the left and right internal mammary artery, one can extrapolate that the use of 2 internal mammary artery grafts may provide additional benefits. Bilateral internal mammary artery grafting can be safely performed in most patients (level II evidence). The late survival in patients with bilateral internal mammary artery grafts is favorable. However, there is as yet no completed randomized trial on this subject. Thus the lack of robust data makes previous reports amenable to criticism. This review examines published data on bilateral internal mammary artery revascularization spanning the last 15 years, and addresses the advantages and disadvantages of arterial conduits in coronary surgery.

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“…2. Accola et al [13] showed that in young patients, BIMAS could be safely used without putting them at higher risk of perioperative morbidity or mortality.…”

Section: Recurrent Angina Re-syrgerymentioning

confidence: 99%

The Impact of Arterial Grafts in Patients Undergoing GABG

Parissis¹,

Soo²,

Al-Alao³

2013

Artery Bypass

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Additional information is available at the end of the chapter http://dx.doi.org/10.5772/54621 . IntroductionGeneral population suffers at -% by angina. Incidence of angina in men and women aged to is % and % respectively. [ ] The prevalence of angina is , people per million. "lmost in undergoes C""G in the US". This means that half a million people undergo C""G around the world per year and . million patients undergo "ngioplasty/ stenting to .Without revscularization angioplasty or bypass four-year survival of patients one, two or three vessels disease is %, % and % respectively. [ ] Moreover, in patients with reduced ejection fraction and heart failure e.g. stroke the respective survival rates are %, % and %. [ ] Clearly -yearsurvival increases with every form of revascularization treatment. Coronary artery bypass grafting C""G remains the gold standard revascularisation strategy for complex vessel coronary artery disease and left mainstem disease.Recent trials such as the SYNT"X have shown that C""G is superior to PCI in most circumstances of coronary artery disease. "lthough there are certain anatomical lesions such as isolated left main disease treatment options to be elucidated, C""G remains the gold standard treatment for severe coronary artery disease. Data from studies such as SYNT"X and "RT confirmed by the National Cardiothoracic Surgery Database have also shown the low mortality risk of C""G.These recent evidence has prompted a rewrite of the european guidelines with regards to revascularisation. It is now recommended that no ad hoc PCI to be performed and all cases of severe coronary disease should be discussed in a multidisplinary setting involving the Heart team .

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Bilateral mammary artery grafting: Avoidance of complications with extended use

Cited by 36 publications

References 27 publications

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

Coronary Artery Bypass Grafting in Patients on Chronic Hemodialysis: Diabetic Nephropathy Versus Nondiabetic Nephropathy

Is there any further advantage of using more than one internal mammary artery? Literature review and analysis

The Impact of Arterial Grafts in Patients Undergoing GABG

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