Long-Term Results of Internal Thoracic Artery Grafting

  • J. F. SabikIII
  • F. D. Loop

12.6 Conclusions

After nearly four decades of coronary artery bypass surgery, internal thoracic artery grafts have proven to be the best conduit for revascularization. They are resistant to arteriosclerosis and have excellent and stable long-term patency. Use of the left internal thoracic artery to revascularize the left anterior descending improves both long-term survival and freedom from cardiac events. The survival benefit of internal thoracic artery grafting increases with time, and patient-related factors, such as age, gender, and left ventricular dysfunction, do not decrease this benefit. Internal thoracic artery grafting of the left anterior descending should be an integral part of nearly all surgical coronary revascularizations.

Use of two internal thoracic artery grafts inmyocardial revascularization further improves long-term outcomes of coronary artery bypass surgery. All patients do not benefit equally or at the same postoperative time, however. The survival benefit in high-risk patients appears sooner after surgery than in low-risk patients. Studies show that not all bilateral internal thoracic artery revascularization strategies are equally effective in improving the long-term outcomes of coronary revascularization, and using the internal thoracic arteries to graft the two most important left-sided coronary arteries may be preferable.


Internal Mammary Artery Internal Thoracic Artery Artery Graft Left Internal Thoracic Artery Bilateral Internal Thoracic Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • J. F. SabikIII
    • 1
  • F. D. Loop
    • 2
  1. 1.Department of Thoracic and Cardiovascular SurgeryThe Cleveland Clinic FoundationClevelandUSA
  2. 2.Department of Thoracic and Cardiovascular SurgeryThe Cleveland Clinic FoundationLyndhurstUSA

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