Right internal thoracic artery through the transverse sinus in myocardial revascularization

Ann Thorac Surg. 1996 Jun;61(6):1708-12; discussion 1712-3. doi: 10.1016/0003-4975(96)00080-X.


Background: This study presents the late patency rate of the right internal thoracic artery (ITA) used in situ through the pericardium transverse sinus to the circumflex artery and its branches.

Methods: From April 1983 to December 1994, 2,642 patients were submitted to myocardial revascularization; 201 of them had bilateral ITAs. The right ITA through the transverse sinus was grafted to obtuse marginal artery in 170 patients (84.5%) and the left ITA was grafted to the anterior descending artery in 188 patients (93.5%). Angiographic studies were performed in 80 patients, 44 patients in the immediate postoperative period and 36 patients in the late follow-up (mean, 51.6 months).

Results: The right ITA was patent in 75 patients (93.7%) and the left ITA was patent in 77 (96.2%). At the late postoperative period, the right ITA was patent in 33 patients (91.6%) and the left ITA was patent in 34 (94.4%).

Conclusions: The right ITA placed through the pericardium transverse sinus has a good long-term patency rate, similar to that observed with the left ITA and superior to that of saphenous vein grafts for myocardial revascularization.

MeSH terms

  • Actuarial Analysis
  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Artery Bypass / methods*
  • Coronary Disease / surgery
  • Coronary Vessels / surgery
  • Diabetes Complications
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Pericardium / surgery
  • Risk Factors
  • Saphenous Vein / transplantation
  • Smoking / adverse effects
  • Survival Rate
  • Thoracic Arteries / transplantation*
  • Vascular Patency