LONG-TERM PATENCY RATE OF RIGHT INTERNAL THORACIC ARTERY BYPASS VIA THE TRANSVERSE SINUS

Background-Although concern regarding patency and possible compromise of graft blood flow by routing the right internal thoracic artery (RIT A) through the transverse sinus has been raised, little is known about long-term patency. Methods and Results-To evaluate long-term patency of in situ RITA bypass via the transverse sinus, our first 115 patient s (94 men, 21 women; mean age, 62.5 years; range, 13 to 77 years) who were alive in 1998 were enrolled for angiographic study. Only good-cal iber grafts with no occlusion, string sign, or significant stenosis we re considered patent. Early postoperative angiography had been perform ed 2 to 3 weeks after surgery in 114 patients. The early patency rates were 97.1% for RITA and 95.4% for left internal thoracic artery (LITA ) grafts. Of 109 long-term survivors, 73 (67.0%) consented to have lat e angiographic restudy at a mean of 59 months (range, 9 to 93 months); 89.9% of RITA and 92.3% of LITA grafts were patent. Cumulative patenc y rates (actuarial curves) at 6 years were 89.3% (95% CI, 85% to 94%) for RITA and 94.5% (95% CI, 92% to 97%) for LITA, the differences not reaching statistical significance (multivariate Cox analysis). Conclus ions-Our study demonstrated good long-term patency of in situ RITA byp ass grafting via the transverse sinus for revascularization of the cir cumflex and diagonal arteries and supports its continued use.