Background: Complete arterial coronary artery bypass grafting (CABG) offers the potential to improve long-term results. However, an increased perioperative risk has been controversially discussed. New operative techniques (skeletonization of the ITA/T-grafts/utilization of the radial artery (RA)) may decrease perioperative risk. We compared the outcome after conventional with that after complete arterial CABG. Material and Methods: Three consecutive groups of patients were analyzed. In group I (n = 50), CABG was performed using left ITA and vein grafts. The other two groups received complete arterial CABG with either both ITA's (group II; n = 52) or left ITA and RA (group III; n = 52). Results: A mean of 3.9 ± 0.8 (I) versus 4.2 ± 0.8 (II) and 3.9 ± 0.9 (III) anastomoses were performed per patient (ns). Mean operating time was significantly prolonged in group II (II: 252 ± 54; p < 0.0001; vs. I: 191 ± 36; III: 203 ± 33). Mean ischemic time was significantly prolonged in group II and III (II: 65 ± 20; p < 0.0001; III: 68 ± 16; p < 0.0001; vs. I: 51 ± 15). Mean bypass time (I: 83 ± 23; II: 95 ± 41; III: 91 ± 21), the rate of postoperative complications and in-hospital mortality (I: n = 0; II: n = 2; III: n =0; ns) showed no significant differences. Conclusions: Complete arterial CABG using modern surgical techniques is as safe as the conventional surgical approach using left ITA and vein graft.
Key words:
Cardiovascular disease - Coronary disease - Coronary surgery - Arteries - Revascularization
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1 Presented at the 3rd Meeting of the Austrian, Switzerland and German Association of Thoracic and Cardiovascular Surgery, February 2000
Dr. med. Olaf Wendler
Klinik für Thorax- und Herz-Gefäßchirurgie Universitätskliniken des Saarlandes
Kirrberger Straße 1
66421 Homburg/Saar
Germany
Phone: 06841/162501
Fax: 06841/162788
Email: chowen@med-rz.uni-sb.de
