Development of arterial revascularization of the myocardium at the Linz general hospital. Personal experiences with 1000 patients
Wimmer-Greinecker, G.; Harringer, W.; Gross, C.; Hartl, P.; Mair, R.; Klima, U.; Brücke, P.
Wiener Klinische Wochenschrift 104(17): 535-537
1992
ISSN/ISBN: 0043-5325 PMID: 1413814 Document Number: 403765
Arterial revascularization of the myocardium, particularly the use of the internal mammary artery (IMA) as a bypass graft in coronary artery surgery has become an established procedure over the past decade. From March 1986 to June 1991, of 2070 patients who underwent coronary heart surgery at our department, revascularization of the myocardium was performed with an IMA graft in 1000 cases, whereby the percentage increased from 10.4% in 1986 to 75.0% in 1991 (p less than 0.01). The range of indications gradually widened throughout the period, age no longer being a contradiction today. One reason for this development is the substantial improvement in IMA preparation technique. No increase was found in rethoracotomy rate or in the rate of perioperative infarctions. The mean age of patients receiving an IMA graft increased from 55.2 years (1986) to 64.7 years (1991) and therefore reflects the change in ranges of indication. 54 IMA jump grafts were anastomosed, in 30 cases bilateral IMAs were used and the IMA was implanted as a free graft twice. In the future these successful results with the implementation of IMA grafts will lead to a further displacement of the saphenous vein as main bypass material.