Long-term patency of the right internal mammary artery used as a coronary bypass conduit and the effect of the recipient vessel

2003 ◽  
Vol 92 (4) ◽  
pp. 460-463 ◽  
Author(s):  
Andrew Rashkow ◽  
Haq Nawaz ◽  
Diana Juhasz ◽  
Bogdan Marcu ◽  
Thomas Donohue
Keyword(s):  
Internal Mammary Artery ◽  
Coronary Bypass ◽  
Recipient Vessel ◽  
Internal Mammary ◽  
The Right

scholarly journals Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts

1985 ◽  
Vol 89 (2) ◽  
pp. 248-258 ◽  
Author(s):  
Bruce W. Lytle ◽  
Floyd D. Loop ◽  
Delos M. Cosgrove ◽  
Norman B. Ratliff ◽  
K!rk Easley ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Coronary Bypass ◽  
Bypass Grafts ◽  
Coronary Bypass Grafts ◽  
Internal Mammary

Branched internal mammary conduit permits non-sequenced total arterial revascularization

2020 ◽  
pp. 021849232097595
Author(s):  
Andrew CW Baldwin ◽  
George Tolis
Keyword(s):  
Internal Mammary Artery ◽  
Coronary Revascularization ◽  
Free Graft ◽  
Total Arterial Revascularization ◽  
Surgical Complexity ◽  
Internal Mammary ◽  
Recent Trends ◽  
The Right ◽  
Overall Mortality

Recent trends in cardiac surgery have encouraged total arterial coronary revascularization, citing advantages in long-term patency and overall mortality. Often relying on sequenced, composite, and free-graft strategies, total arterial coronary revascularization is limited by conduit availability and surgical complexity. We present the use of bilateral internal mammary artery grafts to achieve nonsequential 3-vessel total arterial coronary revascularization using the preserved distal bifurcation of the right internal mammary artery. Utilization of distal internal mammary artery branches should be considered a viable strategy in select patients and can broaden the opportunities for total arterial coronary revascularization in patients with multivessel coronary disease.

Pressure Increases Inert Particle Uptake in Human Saphenous Vein

2000 ◽  
Author(s):  
M. J. MacLennan ◽  
B. J. Leavitt ◽  
J. D. Schmoker ◽  
N. C. Chesler
Keyword(s):  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
The United States ◽  
Human Saphenous Vein ◽  
Particle Uptake ◽  
Internal Mammary

Abstract Cardiovascular disease is one of the leading causes of death in the United States, and coronary artery bypass graft surgery (CABG) is one of the mainstays of treatment for this disease (Niklason et al., 1999). Since artificial vascular grafts suitable for coronary bypass are not yet available, the autologous internal mammary artery (IMA) and saphenous vein are used to bypass diseased tissue (Niklason et al., 1999). While IMA grafts have high long-term patency rates, a saphenous vein grafted into the arterial position tends to stenose and eventually thrombose.

Right Internal Mammary Artery Use in 140 Robotic Totally Endoscopic Coronary Bypass Cases: Toward Multiarterial Grafting

2017 ◽  
Vol 12 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Husam H. Balkhy ◽  
Sandeep Nathan ◽  
Susan E. Arnsdorf ◽  
Dorothy J. Krienbring
Keyword(s):  
Internal Mammary Artery ◽  
Length Of Hospital Stay ◽  
Coronary Bypass ◽  
Beating Heart ◽  
Arterial Graft ◽  
Flow Measurements ◽  
Artery Graft ◽  
Internal Mammary Artery Graft ◽  
Internal Mammary ◽  
The Right

Objective Benefits of adding a second arterial graft in coronary bypass are well documented. In patients requiring mulitvessel grafting robotic totally endoscopic coronary bypass (TECAB) has allowed for routine harvesting and use of the right internal mammary artery (RIMA). We retrospectively reviewed the technical considerations and target choice in 140 cases of beating heart TECAB where a RIMA graft was used. Methods In 2008, we introduced beating heart TECAB with anastomotic connectors into our practice, first with single IMA and then with bilateral internal mammary artery. A robotic stabilizer was used not only to facilitate exposure of the coronary targets but also to aid the RIMA harvest using a skeletonized approach. Flow measurements were obtained routinely. We reviewed the technical aspects, target choice, and intraoperative flows in our TECAB patients who underwent grafting with RIMA grafts. Results From February 2008 to January 2015, a total of 404 patients underwent beating heart TECAB with anastomotic connectors, of which 194 (48%) were mulitvessel procedures. One hundred forty patients (35%) had a RIMA graft and constitute the patient population for this review. One hundred thirty-one RIMA grafts were harvested via left-sided ports and grafted to left coronary targets, and nine RIMA grafts were harvested via right-sided ports and grafted to the right coronary artery. Flow was greater than 25 mL/min (pulsatility index < 2) in 95% of grafts. Perioperative mortality was 0.7% and mean ± standard deviation length of hospital stay was 3.1(1.5) days. The RIMA was used as an in situ graft in 124 cases (84%) and as a free T-graft in 24 cases (16%) cases. Right internal mammary artery graft use in all TECABS increased from 23% in the first 5 years to 53% in the last 2 years. Conclusions Robotic TECAB allows the routine harvesting and use of the RIMA graft in a safe and reproducible manner. Skeletonization and sternal sparing allow the RIMA to reach various coronary targets. Further studies are needed for this approach to impact the adaption of multiarterial grafting.

The GraftConnector Experience

Swiss Surgery ◽  
2001 ◽  
Vol 7 (5) ◽  
pp. 209-210 ◽  
Author(s):  
Piergiorgio Tozzi ◽  
Jan Otto Solem ◽  
Boumzebra ◽  
Antonio Mucciolo ◽  
Xavier Mueller ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Long Term Results ◽  
Sheep Model ◽  
Adult Sheep ◽  
Internal Mammary ◽  
The Mean ◽  
The Right

Background: A device to perform sutureless end-to-side coronary artery anastomosis has been developed by means of stent technology (GraftConnector). The present study assesses the long-term quality of the GraftConnector anastomosis in a sheep model. Methods: In 8 adult sheep, 40-55kg in weight, through left anterior thoracotomy, the right internal mammary artery (RIMA) was prepared and connected to the left anterior descending artery (LAD) by means of GraftConnector, on beating heart, without using any stabiliser. Ticlopidine 250mg/day for anticoagulation for 4 weeks and Aspirin 100mg/day for 6 months were given. The animals were sacrificed after 6 months and histological examination of anastomoses was carried out after slicing with the connector in situ for morphological analysis. Results: All animals survived at 6 months. All anastomoses were patent and mean luminal width at histology was 1.8 0.2mm; mean myointima hyperplasia thickness was 0.21 0.1mm. Conclusions: Long-term results demonstrate that OPCABGs performed with GraftConnector had 100% patency rate. The mean anastomotic luminal width corresponds to mean LAD's adult sheep diameter. We may speculate that myointima hyperplasia occurred as a result of local device oversizing.

Biology of bypass vessels and their relation to patency and disease

2021 ◽  
pp. 23-30
Author(s):  
Thomas F. Lüscher
Keyword(s):  
Coronary Artery ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Artery Bypass Graft ◽  
Bypass Grafts ◽  
Current Standard ◽  
Internal Mammary ◽  
The Right

Current standard surgical technique in patients undergoing coronary bypass grafting involves the use of an internal mammary artery (also known as an internal thoracic artery) bypass graft, in general to the left anterior descending coronary artery, and in many centres also the use of the right internal mammary artery to the right coronary artery. Several clinical studies have shown the superiority of mammary artery bypass grafts for survival of patients compared to the use of venous bypass grafts alone. Indeed, the internal mammary artery has several biological features, discussed in this chapter, that are remarkable and of great interest for biologists, cardiologists, and surgeons alike.

Right Gastroepiploic Artery in Myocardial Revascularization: Portuguese Experience

1995 ◽  
Vol 3 (2) ◽  
pp. 71-74
Author(s):  
José Roquette ◽  
Jorge Ouininha ◽  
Nelson Castelão ◽  
Filipe Robalo ◽  
Duarte Serra e Melo ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Gastroepiploic Artery ◽  
Inferior Wall ◽  
Perioperative Myocardial Infarction ◽  
Arterial Revascularization ◽  
Right Gastroepiploic Artery ◽  
Internal Mammary ◽  
The Right

Excellent results obtained with the use of the internal mammary artery in myocardial revascularization led us to complement its use with other arterial conduits, and the right gastroepiploic artery (RGEA) emerged as a valid alternative, allowing the expansion of total arterial revascularization. From July 1988 until September 1994 we utilized the RGEA in 101 patients with ages between 30 and 71 years (mean 54 9.43). The RGEA was used to bypass the posterior descending artery in 90 patients and for the marginal branches of the circumflex in 11. Exclusive arterial revascularization was possible in 92% of the cases with a mean of 2.7 bypasses per patient. There were 4 (4%) cases of death, and 3 instances of perioperative myocardial infarction. Angiographic control of the RGEA performed in 46 patients showed a patency of 87%. In conclusion, the RGEA was predominantly used to revascularize the inferior wall of the myocardium as a complement to the internal mammary artery. Its use occurred without significant morbidity and mortality, and postoperative angiographic visualization of these arterial conduits allowed us to expect good mid-and long-term patency.

Pressure Increases Inert Particle Uptake in Human Saphenous Vein

2000 ◽  
Author(s):  
M. J. MacLennan ◽  
B. J. Leavitt ◽  
J. D. Schmoker ◽  
N. C. Chesler
Keyword(s):  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
The United States ◽  
Human Saphenous Vein ◽  
Particle Uptake ◽  
Internal Mammary

Abstract Cardiovascular disease is one of the leading causes of death in the United States, and coronary artery bypass graft surgery (CABG) is one of the mainstays of treatment for this disease [1]. Since artificial vascular grafts suitable for coronary bypass are not yet available, autologous internal mammary artery (IMA) and saphenous vein are used to bypass diseased tissue [1]. While IMA grafts have high long-term patency rates, saphenous vein grafted into the arterial position tends to stenose and eventually thrombose.

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