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Isolated bypass grafting of the left internal thoracic artery to the left anterior descending coronary artery  Rosalyn Scott, MDa, Eugene H. Blackstone,

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Presentation on theme: "Isolated bypass grafting of the left internal thoracic artery to the left anterior descending coronary artery  Rosalyn Scott, MDa, Eugene H. Blackstone,"— Presentation transcript:

1 Isolated bypass grafting of the left internal thoracic artery to the left anterior descending coronary artery  Rosalyn Scott, MDa, Eugene H. Blackstone, MDa,b, Patrick M. McCarthy, MDa, Bruce W. Lytle, MDa, Floyd D. Loop, MDa, Jennifer A. White, MSb, Delos M. Cosgrove, MDa  The Journal of Thoracic and Cardiovascular Surgery  Volume 120, Issue 1, Pages (July 2000) DOI: /mtc Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

2 Fig. 1 Prevalence of incomplete revascularization across calendar date. The filled circles represent the proportion of each calendar year’s LITA-LAD grafting cases with incomplete revascularization, defined as 50% or greater obstructions in the RCA or LCx coronary systems. The solid line is a Lowes approximation to the distribution of this prevalence, performed in S-Plus with the use of default options.28 The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

3 Fig. 2 Survival after LITA-LAD conventional coronary artery bypass grafting (CABG). A, Survival. The nonparametric (small dots) and parametric (smooth curves) estimates are presented as described in the “Methods” section. The dash-dot-dash line is an age-sex–matched US population life table estimate for these same patients. B, Hazard function. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

4 Fig. 3 Survival impact of incomplete revascularization. Survival, depicted as in Fig 1, is shown for LITA-LAD grafting patients stratified according to the presence (incomplete revascularization, open circles ) or absence (complete revascularization, filled circles ) of important (50% or more diameter obstruction) lesions in non-LAD systems. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

5 Fig. 4 Effect of left main disease on survival. Patients with any left main disease at the time of isolated LITA-LAD grafting are shown by the open circles and parametric curves. The upper parametric curves represent a risk-unadjusted depiction of all patients with absence of lesions in the left main trunk or RCA or LCx systems (no non-LAD disease). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

6 Fig. 5 Impact of LCx system disease on survival. Survival is depicted as in Fig 4, where the circles and lighter parametric curves represent patients with high-grade (70% or more) lesions in any portion of the LCx system and the squares and heavy parametric curves represent a subset of these patients with high-grade lesions in the lateral branches of the LCx system. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

7 Fig. 6 Impact of RCA system disease on survival. The depiction is as in Fig 4. The circles represent patients with high-grade (70% or more) lesions in the proximal RCA. In contrast, patients with RCA system disease of 50% or more and without left main or LCx disease (with or without other disease in the LCx system) are shown by the squares. These latter patients were not shown by multivariable analysis to be at increased risk of late mortality (Table IV). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

8 Fig. 7 Freedom from reintervention (either PTCA or reoperation). The depiction is as in Fig 2. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

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