Bilateral sceletonized internal mammary arteries for myocard-ial revascularization in elderly patients
Živojin S Jonjev1
Ilija Bjeljac2
Aleksandar M Milosavljević2
Mirko Todić2
Strahinja Mrvić2
Novica Kalinić3
1.Institute for Cardiovascular Diseases of Vojvodina,Clinic of Cardiovascular Surgery,Sremska Kamenica,Serbia;Univers-ity of Banja Luka,Faculty of Medicine,Banja Luka,Republic of Srpska,Bosnia&Herzegovina2.Institute for Cardiovascular Diseases of Vojvodina,Clinic of Cardiovascular Surgery,Sremska Kamenica,Serbia3.Univers-ity of Banja Luka,Faculty of Medicine,Banja Luka,Republic of Srpska,Bosnia&Herzegovina
摘要：BACKGROUND Bilateral internal mammary arteries(BIMAs)as the most advanced surgical option for coronary artery bypass grafting(CA-BG)are usually recommended for younger patients without traditional risk factors.This study compares outcomes in propensity score-mat-ched patients aged over 70 years who received BIMAs versus those who received a single internal mammary artery(SIMA).
METHODS From 2013 to 2024,8123 patients underwent primary CABG for multivessel coronary artery disease at our institution.BIMA graft-ing was performed in 1233 patients(15.17%),with in situ BIMA grafting in 290 patients(3.57%).For in situ BIMA group,the right internal mam-mary artery was used to revascularize the right coronary artery,while the left internal mammary artery was utilized for the left anterior descend-ing artery.BIMA patients aged over 70 years(n=79)were compared with SIMA patients(n=79)using propensity score matching.Primary out-come was all-cause mortality at 30 days and 8 years.Secondary outcomes included length of hospital stay,incidence of postoperative major adv-erse cardiovascular and cerebrovascular events,sternal wound infection and the need for subsequent percutaneous revascularization.
RESULTS There was no difference in immediate postoperative primary and secondary outcomes.Mean follow-up was 8.3±1.0 years with an 8-year freedom from death of 67.08%±1.1%in the BIMA group versus 58.22%±0.9%in the SIMA group(P<0.05).
CONCLUSIONS BIMAs as in situ grafts can be successfully used in CABG for patients aged 70 years and older.Consequently,the refined techniques for constructing internal mammary artery grafts used in this study challenge traditionally accepted limitations regarding the use of BIMAs.
机标关键词：revaarteriesbilateralelderlyinternalmammarymyocard-ialpatients
论文发表日期：2025-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 415-422 )