Randomized trial to compare bilateral vs. single internal mammary coronary artery bypass grafting: 1-year results of the Arterial Revascularisation Trial (ART)

Taggart, David P.; Altman, Douglas G.; Gray, Alastair; Lees, Belinda; Nugara, Fiona; Yu, Ly–Mee; Campbell, Helen; Flather, Marcus

doi:10.1093/eurheartj/ehq318

Cited by 336 publications

(236 citation statements)

References 28 publications

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“…In fact its beneficial impact on survival may be delayed by as much as a 7 to 10 years but persists beyond that time period; thus, it may be less appreciated in older patients with coexistent morbidities and limited life expectancy [21][22][23][24]. Of note, in the largest randomized trial investigating the impact of using a second arterial graft [25], mean age at randomization was 63 years and the prevalence of diabetes on insulin was 5.6% only.…”

Section: Discussionmentioning

confidence: 99%

Are three arteries better than two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long-term survival

Benedetto

Caputo

Zakkar

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Are three arteries better then two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long term survival. Umberto Central messageLong term survival in the context of bilateral internal thoracic artery grafting is not extended by using the radial artery in preference to saphenous vein in select low risk patients. Perspective statementLong term survival in the context of bilateral internal thoracic artery grafting is not extended by using the radial artery as the third arterial conduit in preference to saphenous vein also in select low risk patients. More data are needed before it is clear whether vein graft should be preferred as third conduit in this setting. AbstractObjective: Whether the use of the radial artery (RA) as third arterial conduit in addition to bilateral internal thoracic artery (BITA) is associated with better survival when compared to BITA plus saphenous vein (SV) remains to be determined. Methods:The study population included a select low risk group of 275 subjects who received BITA grafting with the RA as third arterial conduit (BITA+RA group) and 489 subjects who received BITA grafting with additional SV graft (BITA+SV). The RA was considered only in case of target stenosis ≥75%. We finally obtained 275 propensity score matched pairs for comparison. Conclusions: Long term survival in a select low risk group of patients receiving BITA grafting was not extended by using the RA as the third arterial conduit in preference to SV.Word count: 248

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Section: Discussionmentioning

confidence: 99%

Are three arteries better than two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long-term survival

Benedetto

Caputo

Zakkar

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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“…At the 1-year interim report, early mortality and major adverse cardiac clinical events were low and similar in both groups. However, the BITA group reported a 1.3% absolute increase in the need for sternal wound reconstruction [22].…”

Section: Introductionmentioning

confidence: 94%

Bilateral versus Single Internal-Thoracic-Artery Grafts

2017

N Engl J Med

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Purpose of Review Several advances have been made in recent years to improve outcome for patients with coronary artery disease. One of the most debated topics regarding surgical treatment with coronary artery bypass grafting (CABG) is graft selection. This review aims to present the current status and scientific evidence for bilateral internal thoracic artery (BITA) grafting. Recent Findings Observational studies and pooled analyses suggest that BITA grafting is associated with improved survival. Early results from a large randomized controlled trial report safety and efficacy of the method. The improved survival might be amplified in select groups, but with an increase in sternal wound-related complications. The benefit of BITA grafts seems to remain to an approximate age of 69 years at surgery. Summary CABG with BITA grafts is likely associated with improved long-term survival at a cost of an increase in sternal wound infections. Ten-year results from the Arterial Revascularization Trial are expected in 2018, providing the best evidence regarding the method yet. Early results show it is a safe method in most patient categories considerable for CABG.

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“…Подтверждается эффектив- ность указанной тактики со значимым снижением час-тоты осложнений при нивелировании факторов риска. Тем не менее в более строгом современном исследо-вании по использованию одной или двух ВГА (arterial revascularization trial) вновь отмечено троекратное уве-личение риска стернотомических осложнений при вы-делении обеих внутренних грудных артерий [27].…”

Section: выбор трансплантатовunclassified

Modern trends in coronary surgery

Акчурин¹,

Shiryaev²,

Vasiliev³

et al. 2017

PKiK

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Based on their 30-year experience, the authors discuss the most important problems in coronary surgery. The modern view on the indications for surgery, as well as on patients selection is presented in the light of the most recent and complete studies. The authors also present the modern approach to surgical technique, choice of graft and describe opportunities offered by microsurgical technique.Received 30 June 2017. Accepted 10 July 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interests.

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Randomized trial to compare bilateral vs. single internal mammary coronary artery bypass grafting: 1-year results of the Arterial Revascularisation Trial (ART)

Abstract: Controlled-trials.com (ISRCTN46552265).

Cited by 336 publications

References 28 publications

Are three arteries better than two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long-term survival

Are three arteries better than two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long-term survival

Bilateral versus Single Internal-Thoracic-Artery Grafts

Modern trends in coronary surgery

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