Berreklouw E, Schönberger J P, Bavinck J H, Verwaal V J, Koldewijn E L, van der Linden F, van der Tweel I, Bredée J J
Department of Cardio-pulmonary Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Ann Thorac Surg. 1994 Jun;57(6):1564-72. doi: 10.1016/0003-4975(94)90124-4.
The hospital morbidity and mortality of 100 patients operated with two internal thoracic arteries with or without additional vein grafts (BITA group) were compared with a matched group of 100 patients operated with one left internal thoracic artery (ITA) on the anterior descending artery with additional vein grafts (LITA control group). In each study group, 3% of the patients had diabetes mellitus. There was no statistical significant difference in hospital mortality (1% versus 0%), perioperative myocardial infarction (5% versus 1%), low cardiac output (3% versus 5%), rethoracotomy (1% versus 0%), lung complications (13% versus 13%), wound complications (8% versus 8%), other cardiac complications (26% versus 16%), other noncardiac complications (1% versus 4%), median duration of stay in the intensive care unit (1 versus 1 day), and mean duration of stay in the hospital (10.4 versus 10.8 days) between the groups. Logistic regression analysis showed that the number of ITAs used was not a predictor of complications. Thus, there is no difference between the BITA and LITA control group in hospital mortality and morbidity (in patients with a low incidence of diabetes). If an improvement in cardiac event-free and reoperation-free survival is to be expected, the use of both ITAs can be continued in similar patients.
将100例接受双侧胸廓内动脉搭桥术（无论是否加用静脉移植物）的患者（BITA组）的医院发病率和死亡率，与100例接受左胸廓内动脉（ITA）在前降支搭桥并加用静脉移植物的匹配患者（LITA对照组）进行比较。在每个研究组中，3%的患者患有糖尿病。两组在医院死亡率（1%对0%）、围手术期心肌梗死（5%对1%）、低心排血量（3%对5%）、再次开胸手术（1%对0%）、肺部并发症（13%对13%）、伤口并发症（8%对8%）、其他心脏并发症（26%对16%）、其他非心脏并发症（1%对4%）、重症监护病房中位住院时间（1天对1天）以及医院平均住院时间（10.4天对10.8天）方面均无统计学显著差异。逻辑回归分析显示，使用的ITA数量不是并发症的预测因素。因此，BITA组和LITA对照组在医院死亡率和发病率方面无差异（糖尿病发病率低的患者）。如果预期无心脏事件和无再次手术生存率有所改善，在类似患者中可继续使用双侧ITA。
