Thorac Cardiovasc Surg 2009; 56 - MP17
DOI: 10.1055/s-0029-1191540

Patency of sequential LITA grafting and separate LITA and venous grafting – a five year follow-up

P Massoudy 1, D Wasserfuhr 1, D Schmidt 1, M Thielmann 1, M Kamler 1, H Kühl 2, H Jakob 1
  • 1Westdeutsches Herzzentrum Essen, Universitätsklinikum, Klinik für Thorax- und Kardiovaskuläre Chirurgie, Essen, Germany
  • 2Universitätsklinikum Essen, Institut für Diagnostische und Interventionelle Radiologie, Essen, Germany

Introduction: The superiority of LITA grafting to the LAD has been well established over the last decades. Patency rates of 80–90% have been reported at 10 and 15 years follow up. The superiority of sequential LITA grafting has not been proven. Our aim was to compare the patency rates after sequential LITA grafting to a Diagonal branch and the LAD with the patency rates after separate LITA grafting to LAD and vein grafting to a Diagonal branch.

Methods: 59 CABG patients, operated between January 2000 and December 2002, underwent multi slice computed tomography (MSCT) between 2006 and 2008. 30 of them had undergone sequential LITA grafting to a Diagonal branch and to the LAD (group 1), in 29 of them LAD and Diagonal branch were separately grafted with LITA and vein grafts (group 2). Patencies of all anastomoses were investigated.

Results: Mean follow-up was 1946±175 days. Patency rate of the LAD anastomosis was 97% in group 1 and 93% in group 2 (p=0.14). Patency rate of the Diagonal branch anastomosis was 97% in group 1 and 85% in group 2 (p=0.07). Mean intraoperative flow on LITA graft was not different between groups (67±8 in group 1 and 68±9 in group 2, p=n.s.).

Conclusion: The patencies of LITA anastomoses were not different between the groups. There was a borderline significant difference between arterial and venous grafts to Diagonal branches, which indicates that, concerning the antero-lateral wall, there is an advantage of sequential arterial grafting compared with separate arterial and venous grafting.