Vineberg Procedure by 'Vineberg technique modified by Lobo Filho': morbidity and mortality in the imediate post operative period, angiography results and flow analyze of the left internal thoracic artery implanted

摘要

BACKGROUND: The Vineberg procedure consists in inserting the internal thoracic artery in the ischemic left ventricle muscle. The main question is the ability of this artery to supply adequate flow for the isquemic miocardium. OBJECTIVES: To evaluate angiographic results of Vineberg procedure by the Vineberg technique modified by Lobo Filho, the morbidity and mortality in the imediate post operative period (POP) and analysis of the flow of the implanted left internal thoracic artery (LITA) at rest and under stress. METHOD: Between September 1999 and April 2002, in our service, eight patients were operated by the above describe technique, in which the implant of the internal thoracic artery in the intimacy of the left ventricle muscle is achieved using a kit used for the introduction of the endocardial leads of pacemakers through the subclavian vein. After six months, they went to angiographic and doppler evaluation. For the LITA study with the doppler we divided the sample into two groups: "Vineberg group", formed by the eigth patients mentioned above; and "control group" formed by 20 patients in whom the LITA recascularize directly the anterior interventricular artery. The angiographic study demonstrade patency of all the grafts in both groups. With the doppler, it was measured the output and flow velocity in the grafts. The analysis of data obtained was taken with T-test for paired and unpaired samples. RESULTS: There were no deaths or complications in imediate POP. The angiographic study showed 100% patency. The total output of Vineberg group was 55% of the ones in the Control group. In both groups, the total output increased with the stress. CONCLUSIONS: The Vineberg technique modified by Lobo Filho can be used with low rates of morbidity and mortality, high index of patency providing a significant blood flow at rest and under stress.