THE ROAD TO COMPLETE ARTERIAL GRAFTING FOR CORONARY-ARTERY DISEASE

In 1984, our department moved to the use of single, and subsequently, bilateral internal thoracic artery grafting which, when reviewed after 12 years, suggest the addition of a second internal thoracic artery i s beneficial. The 10-year survival using all-cause mortality was 86.9% for bilateral internal thoracic artery grafting compared with 74.2% f or the use of a single internal thoracic artery graft. The mortality r ate ratio for single versus bilateral internal thoracic artery grafts was 1.4 (P=0.009). In 1995, we entered an era of total arterial grafti ng using combinations of radial and internal thoracic arteries. There have been no additional early complications in the first 2 years, furt hermore the early results show that the postoperative creatinine kinas e MB isoenzyme and the myocardial infarction rates were lower in patie nts receiving at least one radial artery graft compared with those not receiving a radial artery graft. Continued use of internal thoracic a nd radial arteries to achieve complete arterial revascularisation for patients with coronary artery disease appears justified. (C) 1997 Else vier Science Ireland Ltd.