Titre du document / Document title

High-dose isosorbide dinitrate for myocardial revascularization with composite arterial grafts

Auteur(s) / Author(s)

GUREVITCH J. ; MILLER H. I. ; SHAPIRA I. ; KRAMER A. ; PAZ Y. ; MATSA M. ; MOHR R. ; YAKIREVICH V. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Departments of Thoracic and Cardiovascular Surgery and Cardiology, Ichilov Hospital, Elias Sourasky Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, ISRAEL

Résumé / Abstract

Background. Composite arterial grafting for myocardial revascularization is a surgical technique in which free arterial conduits are proximally attached to an in situ internal mammary artery. Methods. Composite arterial grafting was performed in 78 patients with internal mammary artery (n = 24), inferior epigastric artery (n = 21), or radial artery (n = 33) connected to the internal mammary artery. Overall, 254 distal anastomoses were performed (average number, 3.3 per patient), 225 of which were arterial. All patients were treated postoperatively with high-dose isosorbide dinitrate (4 to 20 mg/h for 24 hours). Results. The in-hospital mortality rate was 2.6% (2 patients). Early recatheterization studies performed 3 weeks (range, 1 to 20 weeks) after operation in 30 patients demonstrated patency rates of 100%, 93%, and 100% for the composite internal mammary artery, inferior epigastric artery, and radial artery groups, respectively. In addition, two inferior epigastric artery conduits had major intraluminal constriction. At a mean follow-up of 20 months (range, 1 to 42 months) all patients are alive, and all but 2 in the inferior epigastric group (97%) are angina free. Conclusions. This surgical technique can be safely used. On the basis of our experience, the right internal mammary artery and the radial artery are the most suitable conduits for this procedure. High-dose nitrates given perioperatively prevent spasm and ensure early patency rates.

Revue / Journal Title

The Annals of thoracic surgery   ISSN 0003-4975   CODEN ATHSAK 

Source / Source

1997, vol. 63, n^o2, pp. 382-387 (24 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1965) (Revue)

Mots-clés anglais / English Keywords

Bypass ; Aortocoronary ; Autotransplantation ; Internal mammary artery ; Radial artery ; Isosorbide dinitrate ; High dose ; Intravenous administration ; Technique ; Result ; Human ; Surgery ; Treatment ; Cardiovascular disease ; Coronary heart disease ; Transplantation ; Chemotherapy ; Intraoperative ; Vasodilator agent ;

Mots-clés français / French Keywords

Dérivation ; Aortocoronaire ; Autotransplantation ; Artère mammaire interne ; Artère radiale ; Dinitrate d'isosorbide ; Dose forte ; Voie intraveineuse ; Technique ; Résultat ; Homme ; Chirurgie ; Traitement ; Appareil circulatoire pathologie ; Cardiopathie coronaire ; Transplantation ; Chimiothérapie ; Peropératoire ; Vasodilatateur ;

Mots-clés espagnols / Spanish Keywords

Derivación ; Aortocoronaria ; Autotrasplante ; Arteria mamaria interna ; Arteria radial ; Dinitrato de isosorbida ; Dosis fuerte ; Vía intravenosa ; Técnica ; Resultado ; Hombre ; Cirugía ; Tratamiento ; Aparato circulatorio patología ; Cardiopatía coronaria ; Trasplantación ; Quimioterapia ; Peroperatorio ; Vasodilatador ;

Localisation / Location

INIST-CNRS, Cote INIST : 13779, 35400006331665.0170