Thirty-Year Follow-Up Defines Survival Benefit for Second Internal Mammary Artery in Propensity-Matched Groups

Kurlansky, Paul; Traad, Ernest A.; Dorman, Malcolm J.; Galbut, David L.; Zucker, Melinda; Ebra, George

doi:10.1016/j.athoracsur.2010.04.006

Cited by 199 publications

(177 citation statements)

References 21 publications

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“…В 2001 году в систематическом обзоре, в котором сравнивали шунтирование с одной ВГА (SIMA), по сравнению с билатеральным шунтированием ВГА (BIMA) была отмечена достоверно лучшая выживае-мость пациентов при шунтировании BIMA, с относи-тельным риском смерти 0,81 [410]. Недавно прове-денные исследования показали, что польза двусто-роннего шунтирования ВГА (BIMA) в отношении выживаемости сохраняется на втором и третьем деся-тилетии периода наблюдения [411,412], и особенно у пациентов с сахарным диабетом [169].…”

Section: Iib B 373-375unclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

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Section: Iib B 373-375unclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

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“…The two seminal retrospective studies from the Cleveland clinic had shown that bilateral ITAs not only confer a survival benefit in patients undergoing CABG (7), but also extend this benefit further as one moves away from the time of surgery (8). Several large meta-analyses (9-11) and propensity-matched observational studies have also confirmed the benefits of bilateral ITA utilization during CABG (12,13). However, the Arterial Revascularization Trial (ART), which is the only randomized controlled trial (RCT) comparing the use of single with bilateral ITA during CABG, revealed no survival benefit or reduction in the rates of cardiovascular events in favour of the latter at least till the 5-year followup mark (14), thereby throwing the debate wide open.…”

Section: Introductionmentioning

confidence: 85%

“…The single most important benefit of using bilateral ITAs is the superior long-term survival, which has been demonstrated by several observational studies (7,8,13) and meta-analyses (9-11). However, long-term survival following off-pump CABG has always been a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

Off-pump coronary artery bypass surgery with bilateral internal thoracic arteries: the Leipzig experience

Davierwala

Leontyev

Garbade

et al. 2018

Ann. Cardiothorac. Surg.

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Background: Contrasting results of recent randomized controlled trials (RCTs) comparing off-pump and on-pump coronary artery bypass graft (CABG) surgery, as well as the lack of evidence for any survival benefit of bilateral internal thoracic artery (ITA) grafting over single ITA use, has intensified the debate about the role of the off-pump technique and bilateral ITA use in CABG surgery. We therefore investigated our 15-year experience in off-pump CABG with bilateral ITA grafting and evaluated temporal trends in preoperative characteristics and postoperative outcomes.Methods: Demographic, intra-operative, and outcome data of 1,199 consecutive patients undergoing offpump CABG with bilateral ITA grafting was prospectively collected in a computerized database. Patients who underwent on-pump cardiac procedures and other extra-cardiac procedures were excluded from this study.Assessment of changes in perioperative characteristics and parameters with time was performed by dividing the whole cohort into three groups (2003-2007, 2008-2012, and 2013-2017) based on the year of surgery. Results:The overall 30-day mortality was 0.6%, with no differences observed between the three time cohorts (0.6%, 0.7%, 0.5%; P=0.8). The perioperative stroke rate for whole cohort was 0.6% and demonstrated a significant reduction in the last two time cohorts (1%, 0.5%, 0.5%; P<0.0001). The overall incidence of deep sternal wound infections was 0.7%, but was marginally higher in the last time-cohort (0.6%, 0.5%, 0.9%; P=0.7). Overall survival for the entire cohort was 92.9%±1% and 78.9%±4% at 5 and 10 years follow-up, respectively. Older age at surgery and presence of peripheral vascular disease were the only predictors of late mortality.Conclusions: Off-pump CABG with bilateral skeletonized ITAs is a safe operation and is associated with a low mortality and morbidity, which can be maintained in high volume center unit over a long period of time.The long-term survival of patients undergoing such an operation is excellent.

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“…The demonstrated clinical advantages of BIMA grafting strategies include prolonged survival and reduced need for coronary reintervention on the basis of recurrent myocardial ischemia, including freedom from the need for coronary reintervention [15,88,90] which hold true for women as well as for men, where it has been demonstrated that use of BIMA had 3-fold improved cardiacrelated survival compared with patients who did not receive an IMA graft [91]. Reported rates of BIMA use in CABG range from 4.0% to nearly 50% depending upon several factors including the contributing authors' practice preferences and the particular patient cohort treated [19][20][21][22]92]. However, it has been estimated that up to 80% would be candidates for BIMA grafting [93].…”

Section: Bilateral Internal Mammary Artery Conduitsmentioning

confidence: 99%