Free Internal Thoracic Artery Grafts for Ischemic Heart Disease : A Medium-Term Follow-Up Study

Seventeen patients underwent coronary revascularization using free internal thoracic artery (ITA) grafts. These patients received 17 free ITA grafts and 17 in situ ITA grafts. Another 16 grafts, 9 autologous vein grafts and 7 right gastroepiploic artery grafts, were also constructed. Thus, an average of 2.9 grafts were constructed per patient. The patency rate of the situ ITA grafts was 100% (14/14) and that of the free ITA grafts was also 100% (14/14). Perioperative morbidity included two reoperations for bleeding and one case of inferior myocardial infarction. One hospital death occurred because of colon perforation and one patient died of cerebral infarction six months after the operation. All 15 survivors were followed up to March 1994, with a mean follow-up period of 43.4 months (range: 30 to 56 months). Fourteen patients were in New York Heart Association functional class I and one was in class II. Cardiac function (evaluated by echocardiography and scintigraphy) showed improvement postoperatively. These data suggest that the use of ITA free grafts is associated with a relatively low mortality and increases the versatility of arterial grafting.

Murakami T, et al