Martins Stevan Krieger, Santos Magaly Arrais dos, Tirado Freddy H Ponce, Martins Francisco C E, Malat Hassan F, Jatene Adib Domingos, Souza Luiz Carlos Bento de
Hospital do Coração - HCor, São Paulo, SP.
Rev Bras Cir Cardiovasc. 2007 Jul-Sep;22(3):291-6. doi: 10.1590/s0102-76382007000300004.
We sought to describe the use of both internal mammary arteries (IMA) in patients with diabetes mellitus (DM) submitted to coronary artery bypass grafting (CABG).
Between January of 1995 to August of 2005, 4.569 patients received isolated CABG in our institution, of these, 1.298 had DM. Mean sample age was 62 years, and total mortality was 2.18% (100 patients). We have used both IMA's in 700 patients, that here are split in two groups, with DM (group I, 148 patients), and without DM (group II, 552 patients). Patient selection for double IMA grafting was based on coronary artery anatomy and sternal bone quality, the later was evaluated during sternal transsection. When these two factors were considered favorable, we harvested both IMA's, not mattering if the patient had or had not DM. During IMA's harvest, care was taken not to open the pleural spaces.
There was small difference between the two groups in terms of morbidity and mortality.
Our data suggest that patients with DM can benefit of double IMA's grafting, with little increase in risk for complications if its application is carefully indicated.
我们试图描述在接受冠状动脉旁路移植术（CABG）的糖尿病（DM）患者中双侧乳内动脉（IMA）的使用情况。
1995年1月至2005年8月期间，我院有4569例患者接受了单纯CABG，其中1298例患有DM。样本平均年龄为62岁，总死亡率为2.18%（100例患者）。我们在700例患者中使用了双侧IMA，这些患者分为两组，一组患有DM（I组，148例患者），另一组没有DM（II组，552例患者）。双侧IMA移植的患者选择基于冠状动脉解剖结构和胸骨质量，后者在胸骨横断时进行评估。当这两个因素都有利时，无论患者是否患有DM，我们都会采集双侧IMA。在采集IMA时，注意不要打开胸膜腔。
两组在发病率和死亡率方面差异较小。
我们的数据表明，DM患者可以从双侧IMA移植中获益，如果谨慎选择适应证，并发症风险增加不大。
