Original ArticlesBilateral internal mammary artery grafting: midterm results of pedicled versus skeletonized conduits
Section snippets
Material and methods
From October 1991 to May 1994, 304 patients underwent isolated myocardial revascularization using pedicled BIMA conduits (group A); from June 1994 to June 1998, 842 patients underwent the same operation using skeletonized BIMA conduits (group B). Table 1shows the preoperative data.
Results
Preoperative data in both groups were not similar, because the population was older, with lower ejection fraction and with more redo patients in group B (Table 1), owing to the modification with time of the coronary population.
The CPB time was longer in group A (69.0 ± 19.9 versus 59.8 ± 19.2 minutes, p < 0.001), but the cross-clamping time was similar (50.5 ± 14.2 versus 51.5 ± 16.8 minutes, not significant, in groups A and B, respectively). However, in 157 patients in group B, CPB was not
Comment
The use of BIMA conduits in coronary artery operations is essentially a technical problem. Even if there is not clear demonstration that in the long term the use of BIMA conduits is superior to the use of a single LIMA on the LAD, plus one or more saphenous vein grafts, there is no clear demonstration of the contrary. This means that, if the use of the second IMA does not give technical problems, there is no reason not to use it.
One of the major concerns is the increase of postoperative
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