J.Jpn. Surg. Soc.. 87(9): 1017-1020, 1986
Report on the annual meeting
MULTIPLE-VESSEL CORONARY REVASCULARIZATION WITH COMBINED SEQUENTIAL VEIN GRAFTS AND OPERATIVE TRANSLUMINAL ANGIOPLASTY
|
Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Tsu, Japan Minoru Kusagawa |
The sequential anastomosis technique and OTCA have been used for revascularization of the patients with multiple vassel diseases, as these techniques are considered to meet above mentioned requirements for myocardial revascularization.
In our clinic, surgical revascularization of myocardium was performed in 417 patients over a period of 13 years from 1973 to 1985. All of these patients received one or more vein grafts and in 54 patients sequential vein grafts were used in addition to the individual grafts. Thus, 633 individual grafts in the 363 patients and 114 anastomoses in the remaining 54 patients with sequential grafts were performed. The patency rate of them was 87% for individual grafts and 94% for sequential grafts. Complete revascularization was achieved in 73% of patients with individual grafts and in 93% of patients with sequential grafts who all had the critical stenosis in three major coronary arteries. The mean blood flow of individual grafts to LAD was 61±25ml/min, contrary to 85±21/min of sequential grafts to diagonal branch and LAD. OTCA combined with AC bypass was performed on 12 distal segments of coronary arteries of 8 patients. All of the segmental stenosis of coronary branches were successfully dilated to 2.0mm in diameter.
Based on these results, we have concluded that the extended use of sequential vein graft and OTCA offers the best chance of complete revascularization as they are technically feasible and provide adequate perfusion to the area of myocardium supplied by such grafts.
To read the PDF file you will need Adobe Reader installed on your computer.