scholarly journals Long-term survival after use of internal thoracic artery in octogenarians is gender related

2015 ◽  
Vol 150 (4) ◽  
pp. 891-899 ◽  
Author(s):  
Arun K. Singh ◽  
Andrew D. Maslow ◽  
Jason T. Machan ◽  
James G. Fingleton ◽  
William C. Feng ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Term Survival ◽  
Long Term Survival

scholarly journals SHORT- AND LONG-TERM OUTCOMES OF A SECOND ARTERIAL CONDUIT FOLLOWING CORONARY BYPASS GRAFTING

2021 ◽  
Author(s):  
Sleiman Sebastian Aboul-Hassan ◽  
Jakub Marczak ◽  
Tomasz Stankowski ◽  
Lukasz Moskal ◽  
Maciej Peksa ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Deep Sternal Wound Infection ◽  
Bypass Grafting ◽  
Short Term ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Arterial Conduit ◽  
Long Term Mortality

Background: The aim of this study was to assess the effect on short-term outcomes and long-term survival in patients following coronary artery bypass grafting in whom second arterial conduit(right internal thoracic artery-RITA or radial artery-RA) or saphenous vein was grafted and between RITA and RA as second best arterial conduit. Methods: Between January-2006 and June-2018, 7857-patients met the inclusion criteria and were divided into two groups: single internal thoracic artery: SITA+Vein group(n=7140) and 2nd-arterial conduit group(n=717), of these 537-patients received RITA and 180-patients received RA. Short‐term outcomes included: 30-day mortality and Major Adverse Cardiac and Cerebral Events(MACCE), reoperation for bleeding and deep sternal wound infection(DSWI). The long‐term outcome was all‐cause mortality. propensity score(PS) matching was used to match patients between the groups. Results: Before as well as after PS-matching, no significant differences were observed between 2nd-arterial conduit vs SITA+Vein groups and between RITA vs RA groups in terms of 30-day mortality, 30-day MACCE, reoperation for bleeding and incidence of DSWI. The use of 2nd-arterial conduit was associated with a significant reduction in long-term mortality before(HR:0.52;95%CI;0.43-0.64;p<0.001) as well as after PS-matching(HR:0.77;95%CI;0.60-0.99;p=0.04). RA and RITA as second arterial conduit had comparable long-term mortality before(HR:1.22;95%CI;0.82-1.82;p=0.3) as well as after PS-matching(HR:0.96;95%CI;0.58-1.58;p=0.87). Conclusions: The use of 2nd-arterial conduit vs vein is associated with improved long-term survival. As for the 2nd-best arterial conduit, RA and RITA had comparable long-term mortality.

Does Bilateral Internal Thoracic Artery Grafting Increase Long-Term Survival of Diabetic Patients?

2006 ◽  
Vol 81 (2) ◽  
pp. 599-607 ◽  
Author(s):  
Ioannis K. Toumpoulis ◽  
Constantine E. Anagnostopoulos ◽  
Sandhya Balaram ◽  
Daniel G. Swistel ◽  
Robert C. Ashton ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Diabetic Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Bilateral Internal Thoracic Artery

Statin Treatment Equalizes Long-Term Survival Between Patients With Single and Bilateral Internal Thoracic Artery Grafts

2009 ◽  
Vol 88 (3) ◽  
pp. 789-795 ◽  
Author(s):  
Michel Carrier ◽  
Mariève Cossette ◽  
Michel Pellerin ◽  
Yves Hébert ◽  
Denis Bouchard ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Statin Treatment ◽  
Term Survival ◽  
Long Term Survival ◽  
Bilateral Internal Thoracic Artery

Left anterior descending artery revascularization with the right internal thoracic artery T-graft: the ‘reverse composite’ configuration

2019 ◽  
Vol 29 (6) ◽  
pp. 830-835
Author(s):  
Yael Ag-Rejuan ◽  
Dmitry Pevni ◽  
Nachum Nesher ◽  
Amir Kramer ◽  
Yosef Paz ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Myocardial Revascularization ◽  
Circumflex Artery ◽  
Term Survival ◽  
Long Term Survival ◽  
Left Circumflex Artery ◽  
Left Anterior Descending Artery ◽  
Composite Grafts ◽  
The Right

Abstract OBJECTIVES The use of bilateral internal thoracic artery graft for myocardial revascularization has improved the long-term survival and decreased the rate of repeat interventions in patients. A key technical factor for complete arterial revascularization is sufficient length of the internal thoracic artery (ITA) graft. The purpose of this study was to compare early and long-term outcomes of ‘standard composite’ grafting and ‘reverse composite’ grafting. In the former, the left ITA (LITA) is connected to the left anterior descending artery, and the right ITA is connected end-to-side to the LITA for revascularization of the left circumflex artery. In ‘reverse composite’ grafting, the LITA is connected to the left circumflex artery, and the right ITA is connected end-to-side to the LITA, for revascularization of the left anterior descending artery. METHODS We compared the outcomes of 1365 patients who underwent coronary artery bypass grafting in Tel-Aviv Sourasky Medical Centre, using bilateral ITA as standard composite versus ‘reverse composite’ grafts, between January 1996 and December 2011. A propensity score matching analysis compared 132 pairs of patients who underwent bilateral ITA by the 2 modes. RESULTS Twelve hundred and thirty patients underwent standard ‘composite’ grafts and 135 underwent ‘reverse composite’ grafts. Early mortality and early adverse effects did not differ significantly between the groups. After matching, the difference in late mortality between the groups was not statistically significant. CONCLUSIONS This study suggests that revascularization of the left anterior descending with the right ITA, arising from an in situ LITA, is safe and provides early outcomes and long-term survival that are not significantly different from those of the standard composite grafting technique. However, there was evidence of better survival in the standard composite group.

scholarly journals Bilateral internal thoracic artery versus single internal thoracic artery: a meta-analysis of propensity score-matched observational studies

2019 ◽  
Vol 29 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Stefano Urso ◽  
Eliú Nogales ◽  
Jesús María González ◽  
Rafael Sadaba ◽  
María Ángeles Tena ◽  
...  
Keyword(s):  
Propensity Score ◽  
Wound Infection ◽  
Risk Ratio ◽  
Internal Thoracic Artery ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Deep Sternal Wound Infection ◽  
Term Survival ◽  
Long Term Survival

Abstract The lack of benefit in terms of mid-term survival and the increase in the risk of sternal wound complications published in a recent randomized controlled trial have raised concerns about the use of bilateral internal thoracic artery (BITA) in myocardial revascularization surgery. For this reason, we decided to explore the current evidence available on the subject by carrying out a meta-analysis of propensity score-matched studies comparing BITA versus single internal thoracic artery (SITA). PubMed, EMBASE and Google Scholar were searched for propensity score-matched studies comparing BITA versus SITA. The generic inverse variance method was used to compute the combined hazard ratio (HR) of long-term mortality. The DerSimonian and Laird method was used to compute the combined risk ratio of 30-day mortality, deep sternal wound infection and reoperation for bleeding. Forty-five BITA versus SITA matched populations were included. Meta-analysis showed a significant benefit in terms of long-term survival in favour of the BITA group [HR 0.78; 95% confidence interval (CI) 0.71–0.86]. These results were consistent with those obtained by a pooled analysis of the matched populations comprising patients with diabetes (HR 0.65; 95% CI 0.43–0.99). When compared with the use of SITA plus radial artery, BITA did not show any significant benefit in terms of long-term survival (HR 0.86; 95% CI 0.69–1.07). No differences between BITA and SITA groups were detected in terms of 30-day mortality or in terms of reoperation for bleeding. Compared with the SITA group, patients in the BITA group had a significantly higher risk of deep sternal wound infection (risk ratio 1.66; 95% CI 1.41–1.95) even when the pooled analysis was limited to matched populations in which BITA was harvested according to the skeletonization technique (risk ratio 1.37; 95% CI 1.04–1.79). The use of BITA provided a long-term survival benefit compared with the use of SITA at the expense of a higher risk of sternal deep wound infection. The long-term survival advantage of BITA is undetectable when compared with SITA plus radial artery.

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