PMID- 8093669
OWN - NLM
STAT- MEDLINE
DCOM- 19930224
LR  - 20190920
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 8
IP  - 1
DP  - 1993 Jan
TI  - Bilateral internal mammary artery grafts in patients with left main coronary 
      artery disease.
PG  - 18-24
AB  - The use of the internal mammary artery (IMA) in myocardial revascularization has 
      been expanded with bilateral and sequential grafting. However, its application in 
      the presence of left main coronary artery stenosis (LMCAS) has not been well 
      established. From September 1983 through December 1990, 280 patients with LMCAS 
      greater than 50% were revascularized (3.4 mean grafts per patient) with bilateral 
      IMA and saphenous vein grafts. Eighty-one were sequential IMA grafts. There were 
      234 males (83.6%) and 46 females (16.4%) with a mean age of 64.4 years (range 39 
      to 84 years). Preoperatively, there were six patients (2.1%) in New York Heart 
      Association (NYHA) Class I, 30 patients (10.7%) in Class II, 130 patients (46.4%) 
      in Class III, and 114 patients (40.7%) in Class IV. Fifty-six patients (20.0%) 
      had an ejection fraction less than 50%. Intraaortic balloon counterpulsation was 
      used preoperatively in 26 patients (9.3%) and intraoperatively in 11 patients 
      (3.9%). There were four hospital deaths (1.4%). Hospital complications included: 
      reoperation for bleeding, 7 patients (2.5%); pulmonary insufficiency, 21 patients 
      (7.5%); perioperative infarction, 14 patients (5.0%); and stroke, 4 patients 
      (1.4%). Follow-up was obtained in 276 hospital survivors (100.0%) with a mean of 
      33.4 months. There were 20 late deaths (7.1%): seven cardiac related and 12 
      noncardiac related. Postoperative assessment reveals substantial functional 
      improvement. These results furnish evidence that bilateral IMA grafts can be 
      accomplished with a low operative risk and can provide excellent functional 
      results in patients with LMCAS.
FAU - Galbut, D L
AU  - Galbut DL
AD  - Miami Heart Institute, Florida.
FAU - Traad, E A
AU  - Traad EA
FAU - Dorman, M J
AU  - Dorman MJ
FAU - DeWitt, P L
AU  - DeWitt PL
FAU - Larsen, P B
AU  - Larsen PB
FAU - Kurlansky, P A
AU  - Kurlansky PA
FAU - Carrillo, R G
AU  - Carrillo RG
FAU - Gentsch, T O
AU  - Gentsch TO
FAU - Galbut, B
AU  - Galbut B
FAU - Ebra, G
AU  - Ebra G
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Constriction, Pathologic/surgery
MH  - Coronary Disease/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Revascularization/mortality
MH  - Postoperative Complications
MH  - Saphenous Vein/transplantation
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 1993/01/01 00:00
MHDA- 1993/01/01 00:01
CRDT- 1993/01/01 00:00
PHST- 1993/01/01 00:00 [pubmed]
PHST- 1993/01/01 00:01 [medline]
PHST- 1993/01/01 00:00 [entrez]
AID - 10.1111/j.1540-8191.1993.tb00572.x [doi]
PST - ppublish
SO  - J Card Surg. 1993 Jan;8(1):18-24. doi: 10.1111/j.1540-8191.1993.tb00572.x.