Bilateral internal mammary artery grafts in patients with left main coronary artery disease

D. L. Galbut, E. A. Traad, M. J. Dorman, P. L. DeWitt, P. B. Larsen, P. A. Kurlansky, Roger Carrillo, T. O. Gentsch, B. Galbut, G. Ebra

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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 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, 103 patients (46.4%) in Class III, and 114 patients (40.7%) in Class IV. Fifty-six patients (20.0%) has 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.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalJournal of Cardiac Surgery
Volume8
Issue number1
StatePublished - Jan 1 1993

Fingerprint

Mammary Arteries
Coronary Artery Disease
Transplants
Coronary Stenosis
Counterpulsation
Myocardial Revascularization
Saphenous Vein
Reoperation
Infarction
Survivors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Galbut, D. L., Traad, E. A., Dorman, M. J., DeWitt, P. L., Larsen, P. B., Kurlansky, P. A., ... Ebra, G. (1993). Bilateral internal mammary artery grafts in patients with left main coronary artery disease. Journal of Cardiac Surgery, 8(1), 18-24.

Bilateral internal mammary artery grafts in patients with left main coronary artery disease. / Galbut, D. L.; Traad, E. A.; Dorman, M. J.; DeWitt, P. L.; Larsen, P. B.; Kurlansky, P. A.; Carrillo, Roger; Gentsch, T. O.; Galbut, B.; Ebra, G.

In: Journal of Cardiac Surgery, Vol. 8, No. 1, 01.01.1993, p. 18-24.

Research output: Contribution to journalArticle

Galbut, DL, Traad, EA, Dorman, MJ, DeWitt, PL, Larsen, PB, Kurlansky, PA, Carrillo, R, Gentsch, TO, Galbut, B & Ebra, G 1993, 'Bilateral internal mammary artery grafts in patients with left main coronary artery disease', Journal of Cardiac Surgery, vol. 8, no. 1, pp. 18-24.
Galbut DL, Traad EA, Dorman MJ, DeWitt PL, Larsen PB, Kurlansky PA et al. Bilateral internal mammary artery grafts in patients with left main coronary artery disease. Journal of Cardiac Surgery. 1993 Jan 1;8(1):18-24.
Galbut, D. L. ; Traad, E. A. ; Dorman, M. J. ; DeWitt, P. L. ; Larsen, P. B. ; Kurlansky, P. A. ; Carrillo, Roger ; Gentsch, T. O. ; Galbut, B. ; Ebra, G. / Bilateral internal mammary artery grafts in patients with left main coronary artery disease. In: Journal of Cardiac Surgery. 1993 ; Vol. 8, No. 1. pp. 18-24.
@article{9a61305334a44c62ab6eb3604d14c371,
title = "Bilateral internal mammary artery grafts in patients with left main coronary artery disease",
abstract = "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 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, 103 patients (46.4{\%}) in Class III, and 114 patients (40.7{\%}) in Class IV. Fifty-six patients (20.0{\%}) has 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.",
author = "Galbut, {D. L.} and Traad, {E. A.} and Dorman, {M. J.} and DeWitt, {P. L.} and Larsen, {P. B.} and Kurlansky, {P. A.} and Roger Carrillo and Gentsch, {T. O.} and B. Galbut and G. Ebra",
year = "1993",
month = "1",
day = "1",
language = "English",
volume = "8",
pages = "18--24",
journal = "Journal of Cardiac Surgery",
issn = "0886-0440",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Bilateral internal mammary artery grafts in patients with left main coronary artery disease

AU - Galbut, D. L.

AU - Traad, E. A.

AU - Dorman, M. J.

AU - DeWitt, P. L.

AU - Larsen, P. B.

AU - Kurlansky, P. A.

AU - Carrillo, Roger

AU - Gentsch, T. O.

AU - Galbut, B.

AU - Ebra, G.

PY - 1993/1/1

Y1 - 1993/1/1

N2 - 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 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, 103 patients (46.4%) in Class III, and 114 patients (40.7%) in Class IV. Fifty-six patients (20.0%) has 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.

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 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, 103 patients (46.4%) in Class III, and 114 patients (40.7%) in Class IV. Fifty-six patients (20.0%) has 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.

UR - http://www.scopus.com/inward/record.url?scp=0027397126&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027397126&partnerID=8YFLogxK

M3 - Article

VL - 8

SP - 18

EP - 24

JO - Journal of Cardiac Surgery

JF - Journal of Cardiac Surgery

SN - 0886-0440

IS - 1

ER -