Total arterial coronary revascularization: techniques and results in 3,220 patients

Tatoulis, James; Buxton, Brian F.; Fuller, John A.; Royse, A.

doi:10.1016/s0003-4975(99)01150-9

Cited by 103 publications

(88 citation statements)

References 17 publications

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“…24 The harvesting technique has been standardized, and a low morbidity has been reported previously. 16,[23][24][25] Dissection is possible during preparation of the left ITA, which reduces operating time and may result in lower perioperative trauma. Although there is a higher propensity to vasospasm of the RA compared with the ITA, 26 excellent midterm patency rates have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is a higher propensity to vasospasm of the RA compared with the ITA, 26 excellent midterm patency rates have been reported. 24 A laparotomy, which is necessary for harvesting of the GEA with its specific perioperative disadvantages, 15 is avoidable. In addition, by use of Allen's test, preoperative bedside testing of an adequate collateral circulation is possible.…”

Section: Discussionmentioning

confidence: 99%

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Complete Arterial Revascularization in Multivessel Coronary Artery Disease With 2 Conduits (Skeletonized Grafts and T Grafts)

Wendler

Hennen²,

Demertzis³

et al. 2000

Circulation

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Background-Complete arterial CABG is a surgical option to improve long-term results in the treatment of coronary artery disease (CAD). Harvesting of multiple arterial grafts is commonly associated with prolonged operating times and increased trauma. By use of new operative techniques (skeletonized grafts and the T-graft approach), CABG in multivessel CAD is now possible with only 2 grafts. We present our experience in the use of these techniques on a routine basis. Methods and Results-Between March 1996 and September 1999, 490 patients (aged 61Ϯ9 years, 20% female) underwent complete arterial CABG. Left ventricular ejection fraction ranged from 15% to 85% (mean 59Ϯ15%). Triple-vessel disease was present in 88% of the patients. The incidence of diabetes mellitus was 32% (14% insulin dependent). Either both internal thoracic arteries (ITAs) (23%) or the left ITA and radial artery (77%) were used as conduits. In 85% of the patients, a T graft was created. Mean operating time was 198Ϯ46 minutes; bypass time, 82Ϯ25 minutes; and ischemic time, 58Ϯ22 minutes. Two to 7 (mean 4.1Ϯ0.9) anastomoses were performed per patient. Perioperative intra-aortic balloon pump was necessary in 12 patients (2.4%). The rate of perioperative myocardial infarction was 1.2%. Sternal complications occurred in 1.0%, and in-hospital mortality was 2.2%. Postoperative coronary angiography in 172 patients (35%) documented excellent patency rates (left ITA 98.3%, right ITA 96.5%, and radial artery 96.6%). Conclusions-Complete

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Complete Arterial Revascularization in Multivessel Coronary Artery Disease With 2 Conduits (Skeletonized Grafts and T Grafts)

Wendler

Hennen²,

Demertzis³

et al. 2000

Circulation

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“…Total arterial revascularization may obviate the concerns of vein graft failure and has been shown to have good shortterm results [80]. However, little evidence is available to suggest that outcomes are improved with "all-arterial" grafting [81].…”

Section: Total Arterial Revascularizationmentioning

confidence: 99%

Conduit Selection for Improved Outcomes in Coronary Artery Bypass Surgery

Atkins¹,

Owen²,

Wolfe³

2012

Special Topics in Cardiac Surgery

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“…Therefore, alternative arterial grafts have been continuously researched. The most commonly used arterial grafts are the left and right internal thoracic [1,2,[5][6][7][8] and radial arteries [9,10]. The inferior epigastric and gastroepiploic arteries are less frequently used [1,5,7,10].…”

Section: Introductionmentioning

confidence: 99%

“…It is well known that arterial grafts provide better patency rates for coronary artery bypass grafting (CABG) than saphenous veins (SV), in both the short and long-term [1][2][3][4][5]. Therefore, alternative arterial grafts have been continuously researched.…”

Section: Introductionmentioning

confidence: 99%

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

Gaiotto

Vianna

Busnardo

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RBCCV 44205-1476 DOI: 10.5935/1678 The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts Ramo descendente da artéria circunflexa lateral femoral é boa opção para revascularização do miocárdio com enxertos arteriais ORIGINAL ARTICLE Abstract Introduction:The descending branch of the lateral femoral circumflex artery is an option for coronary artery bypass grafting.Objective: To evaluate the early patency and adaptation of lumen diameter using multidetector computed angiotomography.Methods: Thirty-two patients were selected to undergo coronary artery bypass grafting using the descending branch of the lateral circumflex artery, the internal thoracic artery, and other grafts. Evaluations were carried out through high resolution computed tomography performed on the 7 th and 90 th postoperative day. Diameters of the descending branch of the lateral circumflex artery and the left internal thoracic artery were measured 3 cm before the distal anastomosis, in the middle portion, and 3 cm after the proximal anastomosis. Diameters were compared using paired t-test (P<0.05).Results: Descending branch of the lateral femoral circumflex artery wDescending branch of the lateral femoral circumflex artery was used in 26 patients, as its use was not viable in six patients (18%). It was used as composite graft in all cases. The anterior descending branch was revascularized by the left internal thoracic artery in all cases. Patency rates of the descending branch of the lateral femoral circumflex artery were 96% and 92%, respectively. No occlusions were observed in the left internal thoracic artery (LITA) and no ischemic events were observed in the descending branch of the lateral circumflex. Descending branch of the lateral femoral circumflex artery increased the lumen diameter in the middle (P=0.001) and distal portions (P=0.006); the left internal thoracic artery (LITA) increased in the middle portion (P=0.001).Conclusion: Similar to the left internal thoracic artery, the descending branch of the lateral femoral circumflex artery showed high patency rate and positive luminal adaptation. This early evaluation confirms the descending branch of the lateral femoral circumflex artery as a potential alternative for grafting. Due to anatomical variations, preoperative femoral angiographic evaluation appears to be mandatory. Descriptors:Tomography. Myocardial revascularization. Coronary disease. 318Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RevThe first case in which the DLFCA was used as a graft in CABG was performed in Japan and was reported by Tatsumi et al. [13], in 1996, when the DLFCA was us...

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Total arterial coronary revascularization: techniques and results in 3,220 patients

Cited by 103 publications

References 17 publications

Complete Arterial Revascularization in Multivessel Coronary Artery Disease With 2 Conduits (Skeletonized Grafts and T Grafts)

Complete Arterial Revascularization in Multivessel Coronary Artery Disease With 2 Conduits (Skeletonized Grafts and T Grafts)

Conduit Selection for Improved Outcomes in Coronary Artery Bypass Surgery

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

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