scholarly journals Whatever happens, two mammary is better than one

2021 ◽  
Author(s):  
Giorgia Bonalumi ◽  
Ilaria Giambuzzi ◽  
Roberto Lorusso ◽  
Michele Di Mauro
Keyword(s):  
Heart Failure ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Free Graft ◽  
Arterial Grafts ◽  
Run Off ◽  
Propensity Analysis ◽  
Internal Mammary ◽  
Better Than

It is well known that the left internal mammary artery (LIMA) should be the first conduit of choice. Similarly, especially in patients younger than 70 years, other conduits should be search among arterial grafts such as right internal mammary artery (RIMA) or radial artery (RA). If the RA can be harvested in the meanwhile of LIMA harvesting without time consuming, it is well established that former one has to be grafted only on presence of a good run-off. One of the main criticisms moved to the use of RIMA are linked to technical difficulties in its harvesting it. Edgar Aranda-Michel and coworkers tried to answer to the age-old question is “RIMA has to be used in situ or free-graft?” In a retrospective study on 667 patients (442 had free RIMA and 245 had free RIMA) that were also matched through propensity analysis (202 patients per group), they did not find any differences between the two groups in the major outcomes, including heart failure specific readmissions. This finding is consistent with the literature, hence the take-home message is whatever happens, two mammary is better than one.

scholarly journals Sequential Grafting of in Situ Skeletonized Left Internal Mammary Artery to the Left Coronary System

2018 ◽  
Vol 59 (4) ◽  
pp. 727-735 ◽  
Author(s):  
Qiang Ji ◽  
LiMin Xia ◽  
YunQing Shi ◽  
RunHua Ma ◽  
JinQiang Shen ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Internal Mammary

scholarly journals The Skeleton in the Closet: Harvesting a Skeletonized IMA

2017 ◽  
Vol 20 (4) ◽  
pp. 178 ◽  
Author(s):  
Curtis G Tribble
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Coronary Bypass ◽  
Arterial Graft ◽  
Heart Team ◽  
Arterial Grafts ◽  
Mammary Arteries ◽  
Internal Mammary ◽  
Optimal Approach ◽  
Excessive Risk

There is a considerable amount of data that using more than one arterial graft provides a survival advantage for patients undergoing coronary bypass operations. The Society of Thoracic Surgeons has a set of official guidelines for the use of arterial grafts which include the following recommendations:Internal mammary arteries (IMA’s) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated.As an adjunct to left internal mammary artery (LIMA), a second arterial graft (right IMA or radial artery [RA]) should be considered in appropriate patients.Use of bilateral IMA’s (BIMA’s) should be considered in patients who do not have an excessive risk of sternal complications.To reduce the risk of sternal infection with bilateral IMA’s, skeletonized grafts should be considered, smoking cessation is recommended, glycemic control should be considered, and enhanced sternal stabilization may be considered.Use of arterial grafts should be a part of the discussion of the heart team in determining the optimal approach for each patient.         [Ann Thorac Surg 2016; 101: 801–9] 

scholarly journals The Use of Arterial Grafts of the Left Internal Mammary Artery is Not a Predictor for the Incidence of Pericardial Effusion

2020 ◽  
Vol 8 (B) ◽  
pp. 231-235
Author(s):  
Slobodan Tomić ◽  
Olivera Djokić ◽  
Srdjan Babić ◽  
Tatjana Raičković ◽  
Slobodan Mićović
Keyword(s):  
Pericardial Effusion ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Arterial Graft ◽  
Venous Graft ◽  
Arterial Grafts ◽  
Internal Mammary ◽  
Study Population ◽  
Surgical Preparation

BACKGROUND: The left internal mammary artery (LIMA) is used very often for coronary artery bypass grafting (CABG). During the cardiac surgery, surgical preparation of LIMA graft could be the reason for mediastinal bleeding and pericardial effusion (PE). AIM: This current study was, therefore, undertaken to show the prediction of PE occurrence comparing the usage of LIMA and venous graft. METHODOLOGY: The study population comprised 1929 patients (1.562 men mean age 57.1 years) who underwent CABG due to coronary disease. Patients were separated into two groups: Patients with venous and patients with arterial grafts on left anterior descending (LAD) artery. The first group included 1468 patients with arterial graft (LIMA) who underwent surgery from October 2008 to January 2014 and the second group included 461 patients with venous graft on LAD that were treated before 2008. Both groups were compared with respect to occurrences, size, and location of PE, which was determined on the 5th day after surgery by echocardiography. RESULTS: PE was identified in 1219 (63.1%) patients. There was no difference between compared groups in the proportional occurrence or absence of effusion: In the first group 931 (63.4%) and in the second 288 (62.4%) patients had PE (p > 0.05). There were significant differences (p < 0.001) in localization of effusion; circular effusion was found in 797 (41.3%) patients while localized effusion in 422 (21.8%) patients. CONCLUSION: Surgical experience can lead to a reduced risk of occurrence of PE when using arterial graft with no differences compared to using a venous graft. The use of arterial LIMA graft is not a predictor for the incidence of PE.

scholarly journals EARLY OUTCOMES

2016 ◽  
Vol 23 (05) ◽  
pp. 583-588
Author(s):  
Tayyab Pasha ◽  
Rafaqat Ahmed ◽  
Muhammad Amir ◽  
Amir Iqbal ◽  
Ayesha Siddiqa
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Arterial Grafts ◽  
Arterial Revascularization ◽  
Off Pump ◽  
Total Arterial Revascularization ◽  
Internal Mammary ◽  
Acute Mi ◽  
Artery Disease ◽  
Vessel Coronary Artery

Objectives: Off pump TACR/MACR performed in experienced hands hascomparable results to on pump TACR/MACR. Period: January-2012 to December-2015.Material and method: 405 patients with two and three vessel coronary artery disease (two &three VCAD) underwent OPCAB at the department of cardiac surgery, Jinnah hospital, Lahore.73 of them got total or multiple arterial coronary revascularizations. 34 patients (41%) hadtwo VCAD and 47 (59%) had three VCAD. Total arterial revascularization was performed in 70(95.8%) patients using right internal mammary artery and left internal mammary artery and/orradial artery. 3 (4.10%) patients got multiple arterial grafts using BITA, RA and SVG. Results:There was no death reported in first 30 days post operatively. Deep sternal wound infectionoccurred in only one patient. The rate of perioperative stroke and renal failure was zero. Two(2.46%) patients had acute MI and 1 patient was reopened due to bleeding. Conclusion: Weconclude that early outcome of OPCAB total or multiple arterial coronary revascularizations, inexperienced hands, are as safe and effective as ONCAB.

scholarly journals Total Arterial Coronary Artery Bypass Grafting – a review article with short experience in Apollo Hospitals Dhaka

Pulse ◽  
2014 ◽  
Vol 5 (1) ◽  
pp. 27-29
Author(s):  
M Quamrul Islam Talukder
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Arterial Graft ◽  
Safe Procedure ◽  
Arterial Grafts ◽  
Internal Mammary ◽  
Artery Disease ◽  
Better Than

Coronary Artery Bypass Surgery (CABG) is an established surgical treatment of coronary artery disease. Conventionally it has been done with left internal mammary artery and saphenous vein for many years. But the study shows that the rate of stenosis of venous graft is much higher than arterial graft in 10 years after CABG1 Recent studies also proved that the outcome of total arterial grafts for CABG is much better than conventional CABG2 In my recent short practice in this hospital, it also proved to be a safe procedure with better early post operative results. DOI: http://dx.doi.org/10.3329/pulse.v5i1.20186 Pulse Vol.5 January 2011 p.27-29

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