Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 29; no. 2; p. 192
• Main Authors: Deininger, Maurilio Onofre, Moreira, Luiz Felipe Pinho, Dallan, Luiz Alberto Oliveira, Oliveira, Orlando Gomes de, Magalhães, Daniel Marcelo Silva, Coelho, José Reinaldo de Moura, Deininger, Eugênia di Giuseppe, Lopes, Norland de Souza, Queiroga, Ricardo Wanderley, Belmont, Elizabeth Ferreira
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01-01-2014
• Subjects: Anastomosis, Surgical; Cardiology; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Heart surgery; Humans; Internal Mammary-Coronary Artery Anastomosis - methods; Male; Mammary Arteries - diagnostic imaging; Mammary Arteries - physiopathology; Medical Illustration; Postoperative Period; Prospective Studies; Risk Factors; Tomography, X-Ray Computed - methods; Treatment Outcome; Vascular Patency - physiology
• DOI: 10.5935/1678-9741.20140032
• EISSN: 1678-9741
• ISSN: 0102-7638

To assess the patency of the pedicled right internal thoracic artery with an anteroaortic course and compare it to the patency of the left internal thoracic artery , in anastomosis to the left anterior descending artery in coronary artery bypass grafting by using coronary CT angiography at 6 months postoperatively.
Between December 2008 and December 2011, 100 patients were selected to undergo a prospective coronary artery bypass grafting procedure without cardiopulmonary bypass. The patients were randomly divided by a computer-generated list into Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used was known at the beginning of the surgery. In G-1, coronary artery bypass grafting was performed using the left internal thoracic artery for the left anterior descending and the free right internal thoracic artery for the circumflex, and in G-2, coronary artery bypass grafting was performed using the right internal thoracic artery pedicled to the left anterior descending and the left internal thoracic artery pedicled to the circumflex territory.
The groups were similar with regard to the preoperative clinical data. A male predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five patients migrated from G-1 to G-2 because of atheromatous disease in the ascending aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20 (SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that all ITAs, right or left, used in situ for the left anterior descending were patent. There were no deaths in either group.
Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic right internal thoracic artery to the left anterior descending artery has an outcome similar to that obtained using the left internal thoracic artery for the same coronary site.