Long-Term patency of on-and off-pump coronary artery bypass grafting with bilateral internal thoracic arteries: The significance of late string sign development in the off-pump technique

Yasunari Hayashi, Atsuo Maekawa, Sadanari Sawaki, Masayoshi Tokoro, Junji Yanagisawa, Takahiro Ozeki, Akihiko Usui, Toshiaki Ito

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES This study aimed to examine the effect of off-pump coronary artery bypass grafting (CABG) in patients who underwent revascularization with bilateral internal thoracic arteries (ITAs). METHODS Between January 2000 and December 2014, 499 patients underwent isolated CABG with bilateral ITAs for complete revascularization of the left coronary system at our institution. On-pump CABG was performed in 137 patients, and off-pump CABG was performed in 362 patients. We retrospectively compared the clinical outcomes and patency of the ITAs. RESULTS The off-pump group showed less respiratory failure and required a shorter postoperative stay than the on-pump group. The survival probability, freedom from cardiac events and early graft patency were similar in both groups. Five-year patency of the ITA anastomosed to the left anterior descending artery was significantly greater in the on-pump group than in the off-pump group (98.8% vs 91.2%, P = 0.010). The incidence of string change in the off-pump group was higher than that in the on-pump group (P = 0.017). There was no significant difference between the groups in the 5-year patency of the ITA anastomosed to the left circumflex artery (on-pump group: 93.8%, off-pump group: 91.8%; P = 0.46). CONCLUSIONS The early graft patency and the late patency of the ITA anastomosed to the left circumflex artery between the groups were similar, implying an equivalent quality of anastomoses. However, the patency of the ITA anastomosed to the left anterior descending artery in the off-pump group showed late deterioration, mainly because of string sign development.

Original languageEnglish
Pages (from-to)799-805
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume25
Issue number5
DOIs
Publication statusPublished - 01-11-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Long-Term patency of on-and off-pump coronary artery bypass grafting with bilateral internal thoracic arteries: The significance of late string sign development in the off-pump technique'. Together they form a unique fingerprint.

  • Cite this