The internal thoracic artery was widely recognized as the ideal graft for coronary artery bypass.
As the use of bilateral ITA grafting was not suitable for complete revascularization due to inadequate conduit length, Tector and al. introduced in the 90’s the T graft. Between January 94 and September 97, we prospectively tested the safety of the technique.
All patients with three vessel disease and age less than 60 were totally revascularized with an internal thoracic arteries T graft. Patients with insulin-dependent diabetes, morbid obesity or severe obstruction airway disease were excluded.
There were 106 patients (96 males, 10 females) with a mean age of 51.5 years. Stress test was performed in 58 patients (55%) with 90% positive results. Ejection fraction ranged from 0.22 to 0.85 with a mean of 0.60. There were no reexploration for bleeding and no death within 30 days after surgery. Three patients had an ECG diagnosed perioperative myocardial infarct without hemodynamic changes. One patient had a sternal wound infection requiring a muscle flap for closure.
Mean follow-up was 26 months (5 to 52 months). Survival rate was 99%. One patient with an ejection fraction of 0.25 died 22 months after surgery. No additional myocardial infarction occurred. Seven patients (6.6%) suffered from recurrent angina. Eighty patients (76%) underwent postoperative stress tests, of which 90% had negative results.
The internal thoracic arteries T graft may be considered as a safe and reliable technique for complete myocardial revascularization in our selected population.