The use of left and right internal thoracic artery grafts for revascularization of the left coronary artery

To analyze the late results of patients who underwent left coronary myocardial revascularization with both internal thoracic arteries, with the right internal thoracic through the transverse sinus. From July/83 to September/96, 233 patients underwent myocardial revascularization, with ages ranging from 35 to 76 (average of 52.8) years. One hundred and eighty five were male and 48 female. Internal thoracic arteries (466), saphenous veins (192) and epigastric arteries (11) were employed. The hospital mortality was 3% and the late mortality was 6.1%. The immediate postoperative bleeding was 0.8%, mediastinitis 1.7% and myocardial infarction 2.1%. The immediate and late coronariography showed the rates of patency, respectively: left internal thoracic artery 98% and 96%, right internal thoracic artery 96% and 92, and saphenous vein grafts 80% and 67.5%. The main advantage in using both internal thoracic arteries in the revascularization of the left coronary branches was the better quality of life, the low rates of cardiac events and the absence of reoperation due to occlusion of the grafts.