Council on Cardio-Thoracic and Vascular Surgery, American Heart Association, Scientific Sessions. New Orleans, LA, USA, 1996/11/10.
Background There is evidence that patients who receive an internal mammary artery graft (IMA) during coronary artery bypass surgery have increased long-term survival.
However, an IMA is not used in all patients.
Methods and Results We studied the use of IMA grafts among 7944 patients undergoing initial, isolated coronary artery bypass surgery in Maine, New Hampshire, and Vermont from 1992 to 1995.
Overall, the IMA graft was used in 82% of patients ; of these, 97.2% had left IMA grafts.
The use of the IMA graft varied considerably by patient and disease factors.
Women received an IMA graft significantly less often (76% versus 85% in men, P<. 01).
Older patients (=75 years) were less likely to receive an IMA graft (67% versus 86%, P<. 001).
Smaller BSA was also associated with lower rates of IMA grafts in both sexes ; however, men and women with BSA<1.8 m2 received an IMA graft at about the same rate.
In general, more sick and more urgent patients had lower rates of IMA use.
Patients with left ventricular ejection fraction<40% received an IMA less often than those with an ejection fraction =60% (77% versus 85%, P<. 01).
Patients with a greater number of diseased coronary vessels received an IMA more often (one, 78% ; two, 82% ; three, 85%). IMA use varied significantly by priority of surgery, with elective patients receiving an IMA 88% of the time, urgent 83%, and emergent 51% (Ptrend<. 01).
The use of the IMA graft varied from 42% to 95% among individual surgeons. (...)
Mots-clés Pascal : Cardiopathie coronaire, Homme, Canada, Amérique du Nord, Amérique, Dérivation, Aortocoronaire, Homogreffe, Technique, Traitement, Artère mammaire interne, Critère décision, Utilisation, Prévalence, Epidémiologie, Appareil circulatoire pathologie, Chirurgie
Mots-clés Pascal anglais : Coronary heart disease, Human, Canada, North America, America, Bypass, Aortocoronary, Homograft, Technique, Treatment, Internal mammary artery, Decision criterion, Use, Prevalence, Epidemiology, Cardiovascular disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0055219
Code Inist : 002B25E. Création : 14/05/1998.