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Title

Impact of double internal thoracic artery grafts on long-term outcomes in coronary artery bypass grafting
Authors
Danzer, Daniel
Christenson, Jan
Kalangos, Afksendiyos
Khatchatourian, Gregory
Bednarkiewicz, Marek
Faidutti, Bernard
Published in Texas Heart Institute Journal. 2001, vol. 28, no. 2, p. 89-95
Abstract We performed this study to determine if bilateral internal thoracic artery grafts provide greater benefit than single internal thoracic artery grafts. Six hundred ninety-four consecutive patients who received 2 coronary grafts in a single operation during 1983-1989 were given 10 years of follow-up and then analyzed retrospectively. Group 1 (n=382) received 2 internal thoracic artery grafts, Group 2 (n= 139) received 1 internal thoracic artery graft and 1 saphenous vein graft, and Group 3 (n= 173) received 2 saphenous vein grafts. Patient demographics, preoperative angiographic findings, and operative indications were the same. Hospital mortality rates were 2.6%, 2.2%, and 2.3%, respectively. Hemorrhage, sternal wound infection, mediastinitis, sternal dehiscence, and prolonged ventilatory support showed no group differences. Follow-up over 10 years was complete in 677 survivors. Mortality rates during follow-up were 1.8%, 2.9%, and 4.7%, respectively. Cardiac-related mortality rates were 71%, 75%, and 88%, respectively (Group 1 vs Group 3, P=0.0412). Ten-year survival was better for Group 1 than for Groups 2 and 3 (P=0.0356 and P <0.0001). Cardiac-event-free survival at 10 years was 93% in Group 1, 84% in Group 2, and 74% in Group 3 (all P <0.0001). The use of 2 internal thoracic artery grafts resulted in significantly lower risk of cardiac death and re-intervention, compared with the use of 1 internal thoracic artery, which in turn was superior to the use of vein grafts. Use of double internal thoracic arteries did not increase postoperative complications.
Keywords Adult — Aged — Coronary Artery Bypass/methods/mortality — Female — Follow-Up Studies — Humans — Male — Middle Aged — Retrospective Studies — Survival Rate — Thoracic Arteries/transplantation — Time Factors — Treatment Outcome
Identifiers
PMID: 11453138
Full text
Article (Published version) (283 Kb) - public document Free access
Other version: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC101146/
Structures
Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research group Chirurgie cardio-vasculaire (105)
Citation
(ISO format) 		DANZER, Daniel et al. Impact of double internal thoracic artery grafts on long-term outcomes in coronary artery bypass grafting. In: Texas Heart Institute Journal, 2001, vol. 28, n° 2, p. 89-95. https://archive-ouverte.unige.ch/unige:47532

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Deposited on : 2015-03-04

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