COMPOSITE ARTERIAL CONDUITS FOR A WIDER ARTERIAL MYOCARDIAL REVASCULARIZATION

From October 1991 to May 1993, 130 patients were submitted to myocardi al revascsularization using complex preformed arterial conduits. The a ge ranged from 29 to 75 years (mean age, 60.1 years); 121 patients wer e male. One hundred twenty-six patients had double- or triple-vessel d isease. The mean ejection fraction was 0.53 (range, 0.22 to 0.79); onl y 6 patients had an ejection fraction less than 0.35. In 6 cases the p rocedure was a reoperation. We used 360 arterial conduits, 163 of whic h as free grafts (3 left internal mammary arteries, 16 right internal mammary arteries, 86 inferior epigastric arteries, 57 radial arteries, and 1 right gastroepiploic artery). One hundred fifty-four free graft s were anastomosed to one or both internal mammary arteries and one to a radial artery. We construtted 136 complex arterial conduits (branch ed, lengthened, or both). In 6 cases a double arterial system had to b e used in a single patient. There was no operative mortality, and no i notropic or mechanical supports were used. The overall mortality rate was 1.5%. Early angiographic controls (between the 7th and 15th postop erative days) demonstrated 100% patency; late angiographic controls (a t a mean interval of 9.5 months after operation) documented a mean pat ency rate ranging from 94.1% of the radial arteries to 100% of the lef t internal mammary arteries and right gastroepiploic arteries. At a me an follow-up of 7.2 months (range, 1 to 15 months) all patients are al ive without recurrence of symptoms.