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Thorac Cardiovasc Surg 2001; 49(1): 5-9
DOI: 10.1055/s-2001-9916
Original Cardiovascular
© Georg Thieme Verlag Stuttgart · New York

Complete Arterial Revascularization in the Diabetic Patient - Early Postoerative Results[*]

O. Wendler1 , B. Hennen2 , T. Markwirth2 , N. Nikoloudakis1 , T. Graeter1 , H.-J. Schäfers1
  • 1Department of Thoracic and Cardiovascular Surgery
  • 2Department of Cardiology University Hospital Homburg/Saar, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

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Background: The prognostic benefit of arterial grafts appears to be particularly high in patients with diabetes mellitus, but has been limited by availability of grafts and sternal complications. Complete arterial coronary artery bypass grafting (caCABG) using skeletonized grafts, radial arteries (RA) and the T-graft approach may reduce the perioperative risk particularly in the diabetic patient. Methods: The perioperative data of 174 diabetic (group I) and 402 non-diabetic patients (group II) who underwent caCABG were studied retrospectively. The operations were performed using bilateral internal thoracic arteries (ITA) (I : 20 %; II : 21 %; ns) or ITA and RA (I : 80 %; II : 79 %; ns). Diabetic patients presented with a higher incidence of 3-vessel disease (I : 93 %; II : 83 %; p < 0.05) and a lower left ventricular ejection fraction (I : 55 ± 16 %; II : 60 ± 16 %; p < 0.05). Results: No differences were found regarding need of intraaortic balloon pump (I : 1.7 %; II : 2.7 %; ns), incidence of myocardial infarction (I : 1.2 %; II : 1.7 %; ns) and sternal complications (I : 2.3 %; II : 1.0 %; ns). In-hospital mortality was 1.7 %(I) versus 2.2 % (II) (p = ns). Conclusions: Using skeletonized arterial grafts and the T-graft approach, caCABG in diabetic patients is as safe as in non-diabetics. With the RA as a second graft, bilateral ITA harvesting is avoidable.

Key words:

Diabetes mellitus - Coronary surgery - Skeletonization - Arterial - Conduits - Radial artery

1 Presented at the 3rd Meeting of the Austrian, Switzerland and German Association of Thoracic and Cardiovascular Surgery, February 2000

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1 Presented at the 3rd Meeting of the Austrian, Switzerland and German Association of Thoracic and Cardiovascular Surgery, February 2000

Dr. med. Olaf Wendler

Klinik für Thorax- und Herz-Gefäßchirurgie Universitätskliniken des Saarlandes

Kirrberger Strasse 1

66421 Homburg/Saar

Germany

Phone: 06841/162501

Fax: 06841/162788

Email: chowen@med-rz.uni-sb.de

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