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dc.contributor.authorShah, Pallav Jen
dc.contributor.authorDurairaj, Manojen
dc.contributor.authorGordon, Ian Ren
dc.contributor.authorFuller, John Aen
dc.contributor.authorRosalion, Alexanderen
dc.contributor.authorSeevanayagam, Sivenen
dc.contributor.authorTatoulis, Jamesen
dc.contributor.authorBuxton, Brian Fen
dc.identifier.citationEuropean Journal of Cardio-thoracic Surgery : Official Journal of the European Association For Cardio-thoracic Surgery; 26(1): 118-24en
dc.description.abstractThe purpose is to define factors influencing long-term patency of the internal thoracic artery (ITA) to optimize the operative strategy.1482 left internal thoracic artery (LITA) and 636 right internal thoracic artery (RITA) symptom-directed angiograms were studied in 1434 patients. Data were prospectively collected from patients who had primary coronary artery bypass surgery during the period 1982-2002. The mean age of patients was 59 years; 85% were male. The mean period from operation to re-angiogram was 80 months. LITA was grafted to left anterior descending coronary artery (LAD) in 82% of cases, RITA to right coronary artery (RCA) in 40% and circumflex artery in 35% of cases. Graft failure was defined as > or =80% stenosis.96.3% of LITA and 88.1% of RITA grafts were patent. No patient variables were significantly associated with graft patency (age, gender, diabetes, hypertension, LVEF, NYHA, AMI). Target coronary artery was associated with patency of both LITA and RITA grafts with maximum patency when grafted to LAD (P = 0.02) RITA had the worst patency to RCA, patency for the left system was identical to LITA. Proximal anastomosis to aorta (free RITA) had significantly better patency when compared with in situ RITA to RCA system (P = 0.005) while similar patency when grafted to left system. ITA diameter and target artery diameter were not associated with graft patency. Recent operations had better RITA patency (P = 0.03). The interval from operation to angiogram was not associated with ITA patency (96% patency for LITA and 88% patency for RITA, remained stable when studied at <1, 1-4, 5-9, 10-14 and >15 years).Even in a patient cohort that had adverse symptoms, excellent LITA and RITA patency was achieved which almost remained constant through all time intervals studied.en
dc.subject.otherCoronary Angiographyen
dc.subject.otherFollow-Up Studiesen
dc.subject.otherGraft Occlusion, Vascular.etiology.radiographyen
dc.subject.otherInternal Mammary-Coronary Artery Anastomosis.methodsen
dc.subject.otherMammary Arteries.radiographyen
dc.subject.otherMiddle Ageden
dc.subject.otherProspective Studiesen
dc.subject.otherRisk Factorsen
dc.subject.otherTreatment Outcomeen
dc.subject.otherVascular Patencyen
dc.titleFactors affecting patency of internal thoracic artery graft: clinical and angiographic study in 1434 symptomatic patients operated between 1982 and 2002.en
dc.typeJournal Articleen
dc.identifier.journaltitleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgeryen
dc.identifier.affiliationDepartment of Cardiac Surgery, Austin Health, Studley Road, Heidelberg, Vic. 3084 Australiaen
dc.type.austinJournal Articleen
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications- Surgery-
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