Myocardial revascularization of the anterior descending artery with classical technique of mammary anastomosis

Introduction and objectives. To establish the results obtained with the cla ssical technique of mammary anastomosis of the anterior descending artery. Material and methods. Between January 1982 and July 1997, 154 patients rece ived an anastomosis of the left internal mammary artery to the left anterio r descending coronary artery with use of the classical technique (sternotom y and extracorporeal circulation). Results. There was no operative mortality in our group, nor paraoperational myocardial infarction, nor cephalic vascular accidents. One (0.6%) patient had sternal wound infection, and another (0.6%) required another reoperati on for postoperational bleeding. All (100%) were followed-up from 3-183 months (average 64.4 months). Actuar ial global survival at 5, 10 and 15 years was 95.6% +/- 2.1; 92.1% +/- 4 an d 85.5 +/- 7.5 respectively, and the actuarial probability of being free fr om cardiac death was 93% +/- 0.9; 99% and 99%. The actuarial probability of being free from myocardial infarction was 99% +/- 0.9; 99% +/- 0.9 and 99%; and from angina was 95% +/- 2.2; 86.9% +/- 4. 9 and 74.5% +/- 12.2 at 5, 10 and 15 years. Finally, the actuarial probability of being free from reoperation was 99% /- 0.9; 99%; 99% and from angioplasty 96.9% +/- 1.7; 91.4% +/- 4.1; 91.4% /- 4.1 at 5, 10 and 15 years, respectively. The average hospital charges in the last 10% of the patients was U$ 6.200. Conclusion. Revascularization of the left anterior descending with the left internal mammary artery and the classical technique (sternotomy and extrac orporeal circulation) is a safe, minimal risk, effective, long lasting and cost efficient procedure with excellent results at 10 and; 15 years.