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Bilateral internal thoracic artery grafting in diabetic patients: Perioperative risk analysis [Anatol J Cardiol]
Anatol J Cardiol. 2004; 4(4): 290-295

Bilateral internal thoracic artery grafting in diabetic patients: Perioperative risk analysis

Murat Mert1, Cihat Bakay2, İhsan Bakır2, Alev Arat Özkan3, Numan Ali Aydemir2
1Department of Cardiovascular Surgery, Cardiovascular Surgery İstanbul University Institute of Cardiology, İstanbul
2Department of Cardiovascular Surgery Istanbul University, İstanbul, Turkey
3Department of Cardiology, Institute of Cardiology, İstanbul University, İstanbul, Turkey

Objective: Diabetic patients have a higher risk to acquire coronary artery disease at younger ages and vein grafts used in these patients have a tendency to develop stenosis earlier. No significant differences have been reported between the patency of internal thoracic artery (ITA) grafts in diabetic and non-diabetic patients. However, bilateral ITA grafting in diabetic patients remains a controversial topic due to increased risks in the perioperative morbidity. Methods: The effects of bilateral ITA grafting on perioperative morbidity for diabetic patients were studied in two different trials. The first study compared 25 diabetic patients with 25 non-diabetic patients with bilateral ITA grafts for the length of the intensive care unit and hospital stay periods, for superficial wound infection, sternal dehiscence, mediastinitis rates and readmissions following discharge. The second study compared 30 diabetic patients with bilateral ITA grafts to 30 diabetic patients with unilateral ITA grafts for the same criteria as in the first study. Results: The first study showed no statistical difference between diabetic and non-diabetic patients for the criteria studied, but a slight increase was clinically observed in the readmission rate for diabetic patients due to superficial wound infection. The second study showed neither statistical, nor clinical differences between the two groups. Conclusion: Full arterial revascularization is very important for the prognosis of diabetic patients. With a careful management, the slight increase in the perioperative morbidity could be reduced to acceptable levels enabling the diabetic patients to benefit from the long-term advantages of bilateral ITA grafting

Keywords: Diabetes, coronary artery bypass graft, internal thoracic artery, superficial wound infection

Diyabetik hastalarda bilateral internal torasik arter kullanım: Perioperatif dönem risk değerlendirmesi

Murat Mert1, Cihat Bakay2, İhsan Bakır2, Alev Arat Özkan3, Numan Ali Aydemir2
1Department of Cardiovascular Surgery, Cardiovascular Surgery İstanbul University Institute of Cardiology, İstanbul
2Department of Cardiovascular Surgery Istanbul University, İstanbul, Turkey
3Department of Cardiology, Institute of Cardiology, İstanbul University, İstanbul, Turkey

Anahtar Kelimeler: Diyabet, koroner arter baypas grefti, internal torasik arter, yüzeysel yara enfeksiyonu.

Murat Mert, Cihat Bakay, İhsan Bakır, Alev Arat Özkan, Numan Ali Aydemir. Bilateral internal thoracic artery grafting in diabetic patients: Perioperative risk analysis. Anatol J Cardiol. 2004; 4(4): 290-295
Manuscript Language: English