Impact of Bilateral Internal Mammary Artery Grafting on the Immediate Outcome: A Double-Edged Sword in a Low Volume Heart Centre

2018 ◽  
Vol 07 (04) ◽  
Author(s):  
Siraphop Thapmongkol ◽  
Patarabutr Masaratana ◽  
Jarun Sayasathid ◽  
Kanthachat Thatsakorn ◽  
Methiniwiran Thapmongkol ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Internal Mammary ◽  
Low Volume

scholarly journals Hospital Volume and Outcome after Bilateral Internal Mammary Artery Grafting

2020 ◽  
Vol 23 (4) ◽  
pp. E475-E481
Author(s):  
Andrea Perrotti ◽  
Daniel Reichart ◽  
Giuseppe Gatti ◽  
Giuseppe Faggian ◽  
Francesco Onorati ◽  
...  
Keyword(s):  
Hospital Volume ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
High Volume ◽  
Mixed Effects ◽  
Hospital Death ◽  
Deep Sternal Wound Infection ◽  
Internal Mammary ◽  
The Mean ◽  
Low Volume

Background: Bilateral internal mammary artery (BIMA) grafting largely is underutilized in patients undergoing coronary artery bypass grafting (CABG), partly because of the perceived increased complexity of the procedure. Aims: In this study, we evaluated whether BIMA grafting can safely be performed also in centers, where this revascularization strategy infrequently is adopted. Methods: Out of 6,783 patients from the prospective multicenter E-CABG study, who underwent isolated non-emergent CABG from January 2015 to December 2016, 2,457 underwent BIMA grafting and their outcome was evaluated in this analysis. Results: The mean number of BIMA grafting per center was 82 cases/year and hospitals were defined as high or low volume, according to this cutoff value. Six hospitals were considered as centers with a high volume of BIMA grafting (no. of procedures ranging from 120 to 267/year; overall: 2,156; prevalence: 62.2%) and nine hospitals as centers with a low volume of BIMA grafting (no. of procedures ranging from 2 to 39/year; overall: 301; prevalence: 9.1%). Multilevel mixed-effects regression analysis showed that the low- and high-volume cohorts had similar outcomes. Propensity score one-to-one matching analysis of 292 pairs showed that the low-volume cohort had a significantly shorter intensive care unit stay (2.2 ± 2.3 versus 2.9 ± 4.8 days, P = .020). The rates of in-hospital death (1.0% versus 0.3%, P = .625), deep sternal wound infection/mediastinitis (3.8% versus 3.1%, P = .824), and 1-year survival (98.1% versus 99.7%, P = .180) as well as other outcomes were similar between the high- and low-volume cohorts. Conclusions: BIMA grafting can be safely performed also in centers in which this revascularization strategy is infrequently performed.

RF44 OUTCOME AFTER BILATERAL INTERNAL MAMMARY ARTERY GRAFTING IN HIGH- AND LOW-VOLUME HOSPITALS

2018 ◽  
Vol 19 ◽  
pp. e70
Author(s):  
M. Saccocci ◽  
A. Perotti ◽  
D. Reichart ◽  
G. Gatti ◽  
G. Faggian ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Internal Mammary ◽  
Low Volume

Impact of Preparation Quality during Skeletonized Internal Mammary Artery Harvesting on Sternal Microcirculation

2020 ◽  
Author(s):  
L. Saemann ◽  
A. Zubarevich ◽  
F. Wenzel ◽  
S. Korkmaz-Icöz ◽  
M. Karck ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Internal Mammary

Mitral Valve Replacement via Anterolateral Right Thoracotomy without Cross-Clamping in a Patient with Fungal Infective Endocarditis and Functioning Internal Mammary Artery after Previous Coronary Artery Bypass Grafting and Mitral Valve Repair

2016 ◽  
Vol 19 (1) ◽  
pp. 033
Author(s):  
Takahiro Taguchi ◽  
Jeswant Dillon ◽  
Mohd Azhari Yakub
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Mitral Valve ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Valve Repair ◽  
Artery Bypass Grafting ◽  
Internal Mammary

A 55-year-old man developed severe mitral regurgitation with persistent fungal infective endocarditis 8 months after coronary artery bypass grafting with a left internal mammary artery and 2 saphenous veins, as well as mitral valve repair with a prosthetic ring. Echocardiography demonstrated severe mitral regurgitation and a valvular vegetation. Computed tomography coronary arteriography indicated that all grafts were patent and located intimately close to the sternum. Median resternotomy was not attempted due to the risk of injury to the bypass grafts, and therefore, a right anterolateral thoracotomy approach was utilized. Mitral valve replacement was performed with the patient under deep hypothermia and ventricular fibrillation without aortic cross-clamping. The patient`s postoperative course was uneventful. Thus, right anterolateral thoracotomy may be a superior approach to mitral valve surgery in patients who have undergone prior coronary artery bypass grafting.

Internal Mammary Artery Bypass Grafting in Left Main Stenosis

Cardiology ◽  
1993 ◽  
Vol 82 (5) ◽  
pp. 343-346
Author(s):  
Reinhard Höltgen ◽  
Ruud Krijne ◽  
Karl-Wilhelm Heinrich ◽  
Hermann Sons ◽  
Arno Krian
Keyword(s):  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Left Main ◽  
Artery Bypass Grafting ◽  
Left Main Stenosis ◽  
Internal Mammary

Survival benefit from a second arterial conduit to the circumflex circulation persists in elderly after coronary artery bypass surgery

2021 ◽  
pp. 021849232199707
Author(s):  
Suvitesh Luthra ◽  
Miguel M Leiva-Juárez ◽  
Pietro G Malvindi ◽  
John S Billing ◽  
Sunil K Ohri
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Survival Benefit ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Arterial Graft ◽  
Arterial Conduit ◽  
Internal Mammary

Background This retrospective propensity matched study investigated the impact of age on the survival benefit from a second arterial conduit to the left-sided circulation. Methods Data for isolated coronary artery bypass surgery were collected from October 2004 to March 2014. All patients with an internal mammary artery graft to left anterior descending artery and additional arterial or venous graft to the circumflex circulation were included. Propensity matching was used to balance co-variates and generate odds of death for each observation. Odds ratios (venous vs. arterial) were charted against age. Results The in-hospital mortality rate was 1.12% (arterial) vs. 1.24% (venous) (p = 0.77). The overall 10-year survival was 74.6% (venous) vs. 82.6% (arterial) (p = 0.001). A total of 1226 patients were successfully matched to the venous or arterial (second conduit to circumflex territory after left internal mammary artery to left anterior descending artery) cohorts. Odds ratio for death (venous to arterial) showed a linear decremental overall survival benefit for the second arterial graft to circumflex circulation with increasing age. Conclusions The survival benefit of a second arterial graft persists through all age groups with a gradual decline with increasing age over the decades. Elderly patients should not be denied a second arterial graft to the circumflex circulation based on age criterion alone.

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