AI Article Synopsis
- The study compares angiographic patency among three types of left internal mammary artery (LIMA) graft configurations: single, sequential, and Y grafts.
- Results showed that single grafts had the highest patency rates, with 3.7% failure in segments, compared to sequential (9%) and Y grafts (6.2%).
- Female patients and those with sequential grafts have lower patency rates for the initial segments of the LIMA, suggesting a preference for single grafts when possible, while Y grafts may be useful when arterial options are limited.
Article Abstract
Background: To maximize arterial grafts, left internal mammary (LIMA) sequential and Y grafts are used. The aim is to compare the angiographic patency of the LIMA in these configurations.
Methods: Between 2002 and 2020, angiography was performed on 1000 patients who either had a single (570), sequential (100), or LIMA y (129) graft. The LIMA was divided into segments (S); S1: LIMA inflow to the first anastomosis, S2: terminal portion of the LIMA to left anterior descending (LAD), and S3; the y-limb anastomosis to a coronary. S1 and S2 patency analysis was carried out with logistic regression.
Results: Failure of the S1 and S2 was 3.7% single, 9% sequential, and 6.2 Y graft (P = .049). Segment 1 failed in 3.7% in single, 5% in sequential, and 0.8% in Y grafts (P = .049). Segment 3 failure was 10.3%. Regression revealed female sex and sequential grafts were associated with decreased S1 and S2 patency.
Conclusions: Single grafts have the best patency. Failure in sequential grafts leads to increased occlusion of the LIMA inflow, whereas Y-graft failure tends to occlude the y limb. When arterial conduit is sparse, a Y graft should be considered.
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| http://dx.doi.org/10.1016/j.jtcvs.2022.02.025 | DOI Listing |
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