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Revista chilena de cirugía

versão On-line ISSN 0718-4026

Resumo

BAHAMONDES S, JUAN CARLOS et al. Anterior descending coronary artery grafting with left internal mammary artery with and without extracorporeal circulation: comparison of two techniques in the long term follow up. Rev Chil Cir [online]. 2007, vol.59, n.5, pp.330-336. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262007000500004.

Background: In recent years the use of left internal mammary artery (LIMA) as a graft to anterior descending artery (DA) with the off pump technique has been associated with similar good long term results as with the on pump technique. Aim: To compare and report the results of LIMA to DA bypass grafting with and without extracorporeal circulation (EC) for isolated DA lesions. Patients and methods: Descriptive study of 85 patients subjected to coronary surgery between 1992 and 2004. Results: Mean age was 62.5 years (DE+9.575, range 35-77 years), 59 were male, ANOVAtest showed no differences between groups related to preoperative risk factors, angiographic characteristics and clinical presentation. 40 patients were operated on pump and 45 off pump. Mean operative time and time in mechanical ventilator were shorter for the off pump group (p<0.005). There was no operative mortality, myocardial infarction, stroke or need of a reoperation in the on pump group. There was a reoperation in 1 patient in the off pump group. In the follow up there were 2 late deaths because of advanced cardiac and chronic renal failure in the on pump group and none in the off pump group. Actuarial survival probability was 96% at 139 months in the on pump group and 98% at 64 months in the off pump group. Conclusions: In this group of patients the use of LIMA as a coronary bypass graft to DA with both techniques is a safe surgical procedure, providing a prolonged time free from cardiac events as mortality, angina, myocardial infarction, and need of a new coronary procedure in the long term follow up

Palavras-chave : Coronary artery bypass (MeSH); internal mammary artery (MeSH); aortocoronary bypass (MeSH); off pump Coronary Artery Bypass (MeSH).

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