From the Thoraxcenter, University Hospital Groningen, the Netherlands.
Correspondence to Jan G. Grandjean, MD, PhD, Department of Cardiothoracic Surgery, University Hospital of Groningen, Hanzeplein 1, 9713 EZ Groningen, the Netherlands. E-mail J.G.Grandjean{at}thorax.azg.nl
Background—In the past 10 years,
there has been a trend to use more arterial grafts instead
of vein grafts for coronary artery bypass graft surgery.
Although there are many reports on the short- and mid-term follow-up of
patients who underwent arterial
revascularization with 1 or 2 arteries, little has
been reported on the follow-up of patients with 3-vessel disease who
received 3 arteries.
Methods and Results—We reviewed a group of 256 patients
with 3-vessel disease who received the right gastroepiploic artery
together with both internal thoracic arteries (ITAs). Vein grafts were
not used in these patients. The patients were monitored for up to 7
years (mean, 51±15 months). Seven-year actuarial survival was 91.1%.
The cumulative probability of event-free survival for myocardial
infarction, reintervention, and angina pectoris at 7 years was 97.3%,
95.4%, and 85.4%, respectively.
Conclusions—We conclude that concomitant use of the
gastroepiploic artery with both ITAs results in low mortality and a low
incidence of myocardial infarction and reintervention at follow-up.
Most interestingly, we found 85.4% freedom from angina pectoris after
7 years, which is considerably lower than the results of studies in
which vein grafts, single ITA grafts, or double ITA grafts are used.
These results strongly support the use of both ITAs and the right
gastroepiploic artery for bypass grafting in patients with 3-vessel
disease.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Low Recurrence of Angina Pectoris After Coronary Artery Bypass Graft Surgery With Bilateral Internal Thoracic and Right Gastroepiploic Arteries
Key Words: angina • arteries • bypass • follow-up studies • revascularization
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