Universität zu Köln

Rustenbach, Christian Joerg, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Gerfer, Stephen ORCID: 0000-0002-6568-6766, Ivanov, Borko, Gaisendrees, Christopher ORCID: 0000-0002-7232-3330, Eghbalzadeh, Kaveh and Wahlers, Thorsten . Multiple Grafting with Single Left Internal Mammary Artery as T-Graft with Itself. Thorac. Cardiovasc. Surg.. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background Revascularization strategies might be limited in patients with lack of sufficient bypass graft material and increased risk of wound healing disturbances. In this regard, we present first results of patients treated with left internal mammary artery (LIMA) as T-graft with itself due to left-sided double-vessel disease, elevated risk of wound healing infection, and lack of graft material. Methods Eighteen patients were retrospectively analyzed in this study. All patients received LIMA grafting, and additional T-graft with itself during off-pump coronary artery bypass surgery. The investigation was focused on intraoperative and postoperative outcomes. Results LIMA-LIMA T-graft was performed in a total of 18 patients. Mean Fowler score accounted for 18.22.9. Severe vein varicosis was present in 9 patients, and 38.9% of patients had lacking venous graft material due to prior vein stripping. A total of 2.5 +/- 0.5 distal anastomoses were performed. Mean flow of LIMA-left anterior descending anastomosis was 41.72 +/- 12.11mL/min with a mean pulsatility index (PI) of 1.01 +/- 0.21. Mean flow of subsequent T-graft accounted for 26.31 +/- 4.22mL/min with a mean PI of 1.59 +/- 0.47. Median hospital stay was 7(6.75;8) days. No incidence of postoperative wound healing disorders was observed and all patients were discharged off hospital. Conclusions LIMA as T-graft with itself to treat left-sided double-vessel disease is feasible and safe in patients with missing bypass graft material and increased risk of deep sternal wound infection. Further prospective studies are necessary to confirm our results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rustenbach, Christian Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Gerfer, Stephen UNSPECIFIED orcid.org/0000-0002-6568-6766 UNSPECIFIED Ivanov, Borko UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaisendrees, Christopher UNSPECIFIED orcid.org/0000-0002-7232-3330 UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-567283
DOI:	10.1055/s-0041-1731758
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STERNAL WOUND-INFECTION; THORACIC-ARTERY; PREDICTORS; REVASCULARIZATION; SURGERY; IMPACT Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56728