Resultados a 5 años de la revascularización exclusiva con dos mamarias en pacientes con enfermedad coronaria multivaso

Resumen

Background: Exclusive coronary revascularization with both mammary arteries could result in lower rates of adverse events in the long term. Aim: To describe the five-year evolution of a cohort of patients operated on with this technique. Material and methods: Follow up analyzing survival of 73 patients aged 59 ± 9 years (82% men) who underwent exclusive coronary surgery with two mammary arteries between December 1, 2010 and April 12, 2017. We studied their clinical characteristics, surgical results, operative morbidity and mortality and adverse events as of June 30, 2018. Results: Six patients had two-vessel lesions and 67 three-vessel lesions. The operative risk calculated by additive and logistic EuroSCORE was 2.5 and 2.3% respectively. A mean of 3.75 anastomoses / patient were performed, 116 with left mammary artery (73 to the anterior descending artery, 38 to a diagonal artery and 5 for other objectives) and 158 with right mammary artery (69 to a first marginal artery, 23 to a second marginal artery and 64 to posterior descending artery). There was one case of mediastinitis and one (1.5%) patient died. The mean follow-up was 64.6 ± 23.7 months. The 5-year survival was 90.4%. Conclusions: Coronary revascularization with two exclusive mammary arteries allowed a complete revascularization of the heart with a low rate of complications and adverse effects at five years.