Techniques and Benefits of Multiple Internal Mammary Artery Bypass at 20 Years of Follow-Up

Rankin, J. Scott; Tuttle, Robert H.; Wechsler, Andrew S.; Teichmann, Tracey L.; Glower, Donald D.; Califf, Robert M.

doi:10.1016/j.athoracsur.2006.10.032

Cited by 92 publications

(78 citation statements)

References 28 publications

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“…Five articles reported information about treatment assignment. [5][6][7][8]10 Although Rankin and colleagues 8 showed a clear principle of patient allocation, with patients allocated prospectively to 2 faculty surgeons with different preferences, the treatment choices were at the discretion of the attending surgeon in the other 4 studies. [5][6][7]10 Four studies had no information on losses to follow-up.…”

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%

“…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%

“…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%

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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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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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“…But it would cause myocardial hemorrhage, edema and even heart failure due to excessive perfusion by high pressure [2]. However, internal mammary artery (IMA), as one kind of muscular artery materials, can enlarge or contract its lumen to adjust the blood flow with strong adaptability [3]. Off-pump coronary artery bypass surgery (OPCAB) has been widely applied as a less invasive method of myocardial revascularization in recent years.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Diffuse Coronary Artery Diseases

Gu-Cheng¹,

Yu²,

Wang³

2013

Artery Bypass

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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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Techniques and Benefits of Multiple Internal Mammary Artery Bypass at 20 Years of Follow-Up

Cited by 92 publications

References 28 publications

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

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

Surgical Treatment for Diffuse Coronary Artery Diseases

Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting

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