The Annals of thoracic surgery | 2021
The growth potential and patency of free right internal thoracic arteries verified by CT angiography.
Abstract
BACKGROUND\nThe use of the left internal thoracic artery (LITA) is a golden standard in coronary artery bypass grafting (CABG). Multi-arterial grafting for CABG is being increasingly emphasized for CABG. This study aimed to solve the utility of the right ITA (RITA) for multiple CABG as free RITA and described new evidence.\n\n\nMETHODS\nOne hundred sixty-three patients received solo CABG with bilateral ITAs between 2005 and 2018. The RITA was used as in situ RITA (Group-A, n=62) and or the composite graft created and saphenous vein graft (SVG) (Group-B, n=101). The patency rate and graft size of the composite free RITA and SVG were examined by coronary computed tomographic angiography (CTA).\n\n\nRESULTS\nThe average number of distal anastomoses per patient was 3.4±1.0 in Group-A, and 4.2±1.1 in Group-B (P<0.001). The sequential grafting with free RITA was in 86 patients. The patency rate of both LITA and RITA was similar in both groups. In Group-B, 40 patients received late CTA at a mean of 46 months (17-175 months). The late patency rate was 95.1% in LITA, and 96.9% in free RITA. The diameter of free RITA increased from 2.06±0.34 to 2.37±0.23 mm (P=0.036); that of in situ LITA increased from 2.08±0.51 to 2.44±0.49 mm (P=0.047), and that of composite SVG decreased from 4.1± 0.9 to 2.6± 0.7 mm (P<0.001).\n\n\nCONCLUSIONS\nMultiple bypass grafting can be sufficiently achieved with LITA and free RITA. The growth potential of free RITA and in situ LITA might be the important role of expected long-term patency.