Mid-to-long-term patency comparison of the right internal thoracic artery grafts on the left anterior descending and on the right coronary arteries

Abstract

Background: The excellent results obtained from internal thoracic artery for myocardial revascularization have led surgeons to simultaneous use of other arterial conduits, particularly the right internal thoracic artery. However, some controversy still exists regarding the optimal target coronary artery for this graft; different strategies have been proposed for bilateral internal thoracic artery grafting. Patients and Methods: 59 patients with right internal thoracic artery grafts were monitored using coronary arteriography in order to compare the patency of this graft on the left anterior descending and the right coronary arteries. The right internal thoracic artery was grafted to left anterior descending artery in 39 patients (group 1) and to right coronary artery in 20 patients (group 2). Results: The mean period of follow-up was 64.07 months (range: 37 to 185 months). Overall, 8 of the 59 grafts (13.6%) were occluded at the arteriography. In group 1, 1 of 39 (2.6%) grafts and in group 2, 7 of 20 (35%) grafts are found to be occluded. These results are considered statistically significant (p<0.001). Comment: The results show that the patency of the right internal thoracic artery is significantly better on the left anterior descending artery than on the right coronary artery in the mid-to-long term, and patency does not differ from the left internal thoracic artery on the left anterior descending artery.