Survival benefit of multiple arterial grafting in a 25-year single-institutional experience: the importance of the third arterial graft

Glineur, David; D’Hoore, William; Price, Joel; Dormeus, Sarah; Kerchove, Laurent de; Dion, Robert; Noirhomme, Philippe; Khoury, Gébrine El

doi:10.1093/ejcts/ezr302

Cited by 79 publications

(76 citation statements)

References 19 publications

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“…6,7,[9][10][11] Table 3 shows the quality assessment of selected studies. None of the studies was randomized or included a description of unbiased treatment assignment.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 9 studies (n=15 583) were selected for meta-analysis (Table 2). [3][4][5][6][7][8][9][10][11] Pair matching was used in 3 studies to create comparable patient groups. [3][4][5] Five studies used propensity score methods to provide comparable samples, 2 using propensity score-based patient matching and 3 using quintilebased stratification.…”

Section: Resultsmentioning

confidence: 99%

“…A significant reduction in mortality by using BIMA was observed by meta-analysis (hazard ratio, 0.79; 95% CI, 0.75-0.84; Figure 2). A subgroup analysis considered studies using different statistical approaches: statistically unmatched, [3][4][5]8 quintile-based propensity score analysis, 7,9,11 and propensity score-based exact patient matching. 6,10 All 3 subgroups showed a survival benefit of BIMA grafting with hazard ratios of 0.81 (95% CI, 0.69-0.94) in the statistically unmatched group, 0.81 (95% CI, 0.75-0.87) in the quintile-based propensity score analysis group, and 0.75 (95% CI, 0.65-0.85) in the propensity score-based exact matching group.…”

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confidence: 99%

“…1 Since then, the potential benefits of bilateral internal mammary artery (BIMA) grafting over single internal mammary artery (SIMA) grafting on survival and cardiac-related events have been emphasized by many investigators. [2][3][4][5][6][7][8][9][10][11] In 2001, our group published a systematic review including a meta-analysis with 15 962 patients with the BIMA group showing a significant reduction in mortality (hazard ratio, 0·81; 95% confidence interval [CI], 0.70-0.94) after a median of 4 years of follow-up with no study showing significantly harmful effect of BIMA grafts. 2 This benefit is likely to be a consequence of documented patency rates of ≥90% for BIMA grafts into the third decade of follow-up in contrast to vein grafts of which three-quarters are occluded or severely diseased by 10 years of follow-up.…”

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confidence: 99%

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Effect of Bilateral Internal Mammary Artery Grafts on Long-Term Survival

et al. 2014

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Background-Although the potential survival benefit of bilateral internal mammary artery (BIMA) grafting in comparison with single internal mammary artery (SIMA) grafting has been emphasized by many investigators, the use of BIMA is still low in clinical practice in the absence of randomized trials and long-term results. In the current study, we aimed to assess if there is a long-term survival benefit of BIMA up to 10 years after coronary bypass surgery. Methods and Results-We selected published articles comparing survival between SIMA and BIMA patients with follow-up duration of more than a mean of 9 years. We evaluated the log hazard ratio with 95% confidence interval for included studies by using a random-effects meta-analysis. Nine eligible observational studies provided 15 583 patients (8270 SIMA and 7313 BIMA) for meta-analysis. Five studies used propensity score methods for statistical adjustment, 2 with a propensity score-based patient-matching method and 3 with quintile-based stratification. A significant reduction in mortality by using BIMA was observed (hazard ratio, 0.79; 95% confidence interval, 0.75-0.84); no study showed any significantly harmful effect of BIMA on survival. Subgroups of studies using different statistical approaches-unmatched, quintile-based propensity score analysis, and propensity score-based exact patient matching-all showed the survival benefit of BIMA grafting. Conclusions-BIMA grafting appears to have better survival with up to 10 years follow-up in comparison with SIMA grafting. Long-term survival benefit of BIMA seems to continue in the second decade after surgery. An ongoing randomized trial comparing SIMA and BIMA groups will add evidence on this issue. The words used for search included "internal mammary (internal thoracic)," "single," "unilateral," "multiple," "bilateral," "artery,", and their combinations using the term "AND." In addition, we searched reference lists of relevant studies, review articles, and meeting abstracts. We included published articles satisfying the following criteria: (1) survival comparison of single and bilateral IMA grafting; (2) long-term results with more than a mean of 9 years of followup; and (3) minimum 100 patients in each group. If any institution reported ≥2 reports on this issue, the latest one was included. Studies were excluded unless the comparability of patient characteristics was controlled either by design or analysis, at least for age, sex, ventricular function, and diabetes mellitus. Only articles published in English were included. All data were extracted independently by 2 reviewers (G.Y. and D.T.). If there were any discrepancies, they were resolved by consensus meeting. In studies where hazard ratios were not given directly, we calculated them by using a spreadsheet method for extracting data from published literature provided by Tierney and colleagues. 17 The primary outcome measurement was death from any cause. Quality Assessment of Selected StudiesFor the quality assessment of studies, we used the same criteria as in o...

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“…6,7,[9][10][11] Table 3 shows the quality assessment of selected studies. None of the studies was randomized or included a description of unbiased treatment assignment.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Bilateral Internal Mammary Artery Grafts on Long-Term Survival

et al. 2014

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“…Therefore, alternative arterial grafts have been continuously researched. The most commonly used arterial grafts are the left and right internal thoracic [1,2,[5][6][7][8] and radial arteries [9,10]. The inferior epigastric and gastroepiploic arteries are less frequently used [1,5,7,10].…”

Section: Introductionmentioning

confidence: 99%

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

Gaiotto

Vianna

Busnardo

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RBCCV 44205-1476 DOI: 10.5935/1678 The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts Ramo descendente da artéria circunflexa lateral femoral é boa opção para revascularização do miocárdio com enxertos arteriais ORIGINAL ARTICLE Abstract Introduction:The descending branch of the lateral femoral circumflex artery is an option for coronary artery bypass grafting.Objective: To evaluate the early patency and adaptation of lumen diameter using multidetector computed angiotomography.Methods: Thirty-two patients were selected to undergo coronary artery bypass grafting using the descending branch of the lateral circumflex artery, the internal thoracic artery, and other grafts. Evaluations were carried out through high resolution computed tomography performed on the 7 th and 90 th postoperative day. Diameters of the descending branch of the lateral circumflex artery and the left internal thoracic artery were measured 3 cm before the distal anastomosis, in the middle portion, and 3 cm after the proximal anastomosis. Diameters were compared using paired t-test (P<0.05).Results: Descending branch of the lateral femoral circumflex artery wDescending branch of the lateral femoral circumflex artery was used in 26 patients, as its use was not viable in six patients (18%). It was used as composite graft in all cases. The anterior descending branch was revascularized by the left internal thoracic artery in all cases. Patency rates of the descending branch of the lateral femoral circumflex artery were 96% and 92%, respectively. No occlusions were observed in the left internal thoracic artery (LITA) and no ischemic events were observed in the descending branch of the lateral circumflex. Descending branch of the lateral femoral circumflex artery increased the lumen diameter in the middle (P=0.001) and distal portions (P=0.006); the left internal thoracic artery (LITA) increased in the middle portion (P=0.001).Conclusion: Similar to the left internal thoracic artery, the descending branch of the lateral femoral circumflex artery showed high patency rate and positive luminal adaptation. This early evaluation confirms the descending branch of the lateral femoral circumflex artery as a potential alternative for grafting. Due to anatomical variations, preoperative femoral angiographic evaluation appears to be mandatory. Descriptors:Tomography. Myocardial revascularization. Coronary disease. 318Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RevThe first case in which the DLFCA was used as a graft in CABG was performed in Japan and was reported by Tatsumi et al. [13], in 1996, when the DLFCA was us...

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Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting

Pu¹,

Ding²,

Shin³

et al. 2017

JAMA Cardiol

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Compared with LITA+SVG, MAG is associated with reduced mortality, repeated revascularization, myocardial infarction, and heart failure among patients with multivessel disease who are undergoing coronary artery bypass grafting without increased mortality or other adverse events at 30 days. The long-term benefits consistently observed across multiple outcomes and subgroups support the consideration of MAG for a broader spectrum of patients who are undergoing coronary artery bypass grafting in routine practice.

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Survival benefit of multiple arterial grafting in a 25-year single-institutional experience: the importance of the third arterial graft

Abstract: In a single-institution experience, the use of multiple arterial grafting is independently associated with superior outcomes. Furthermore, the use of a third arterial conduit (RGEA) targeted to the right coronary artery should be considered to improve long-term survival.

Cited by 79 publications

References 19 publications

Effect of Bilateral Internal Mammary Artery Grafts on Long-Term Survival

Effect of Bilateral Internal Mammary Artery Grafts on Long-Term Survival

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting

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