Off-Pump, In Situ Internal Thoracic Artery Grafting: A Durable Treatment for Single-Vessel Coronary Artery Disease

The value of off-pump in situ left internal thoracic artery to left anterior descending coronary artery bypass grafting in single-vessel coronary artery disease was assessed by long-term angiographic and clinical data. One-hundred three randomly selected patients (87 male, 16 female; mean age, 57.4 ± 10.5 years) underwent postoperative angiographic control after an average postoperative period of 4.8 ± 2.9 years (up to 8.2 years; a total of 490 patient-years). Fifty-five patients (52%) were asymptomatic, whereas 31 (30%) had anginalike chest pain. Ninety-seven patients (94.2%) were in New York Heart Association class I or II. Five-year angina-free survival was 81% ± 5%. Of 103 left internal thoracic arteries assessed, 99 were patent (overall patency, 96.1%). All four cases having occluded grafts had mild native vessel stenoses (