Date: 17 Dec 2010

Total arterial revascularization in multivessel coronary artery disease with left and right internal thoracic artery: the Y graft technique

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Abstract

Background

Many different surgical techniques for total arterial grafting have been reported. We reported our results of double mammary Y graft for total arterial revascularization in the treatment of multivessel ischemic heart disease.

Materials and Methods

Between January 2003 and September 2009, 452 patients underwent myocardial revascularization using two internal mammary arteries in a y-graft configuration. The mean age was 61 ± 8.7 years. 399 patients (88.3%) were male. The preoperative data were collected retrospectively.

Results

The mean number of anastomosis for patients was 3.7 (range 2–6). The mean cross-clamp time was 44.6 min (range 16–106 min), and the mean extracorporeal circulation time was 56.9 min (range 22–175 min). Eleven patients were operated off-pump (2.4%). The in-hospital mortality was 0.8% (4/452 patients). The incidence of peri-operative infarction was 0.4%, re-operation for bleeding 7.1% and deep sternal wound infection 3.1%. The actuarial survival rate was 98.4 ± 1.1% at 3 years, and the freedom from re-intervention was 100%.

Conclusion

In our experience the double mammary Y configuration provides a simple and reproducible technique that allows a complete revascularization in multivessel disease with very low morbidity and mortality. The follow-up of our patients confirmed the effectiveness of the procedure in term of survival, re-intervention and symptoms relief.