Arterial conduits in coronary bypass surgery: Iraqi experience

Abstract

Background: The arterial conduits in coronary artery bypass grafting CABG surgery using bilateral internal thoracic arteries BITA have conferred popular acceptance for special characteristics they have that implicated in better long-term patency rates than other conduits. The radial artery RA may consider an equivalent to Right ITA as a second conduit. The vein graft patency limits the long-term patency and free event survival. Total arterial revascularization TAR is expected to be beneficial for long-term outcome. Objective: The aim of this review is to evaluate our initial experience in using total arterial conduits in selected patients. Methods: Cross-sectional study was conducted in Ibn Al-Bitar hospital during 2 years, 2015-2016. Twelve patients were selected to receive TAR, 11 were males and 1 was female. Their ages ranged from 37-59 years, mean 46.8. No major risk factor for sternal infection was present in the selected patients apart from controlled non-insulin dependent diabetes mellitus NIDDM. Results: Seven patients received TAR. Still, five patients had saphenous vein graft SVG in addition to achieve complete revascularization. Left internal thoracic arteries LITA have always used as pedicle. Right internal thoracic artery RITA used as pedicle or in situ artery in 2 cases and as a free graft in 8 cases. No postoperative complication reported apart from re-exploration in one case due to postoperative bleeding. No sternal wound infection. No early or intermediate mortality was reported for follow up period ranging from 4 months-2 years. All patients were free of ischemic events during follow-up period. Conclusion: In conclusion, the TAR is a feasible approach with satisfactory results in selected patients.