Does the right internal thoracic artery or saphenous vein graft offer superior revascularization of the right coronary artery?

Interactive Cardiovascular and Thoracic Surgery
Dayal MukherjeeThanos Athanasiou

Abstract

A best evidence topic was written according to a structured protocol. The question addressed was whether the right internal thoracic artery (RITA) provides a superior outcome for revascularization of the right coronary artery (RCA) compared with the saphenous vein graft (SVG). Using a designated search strategy, 226 articles were found, of which five represented the best available evidence. The authors, journal, date, country of publication, study type, patient group studied, relevant outcomes and results were tabulated. Of these five studies, one offered level I evidence (data from a randomized trial) and four were level II studies (reports of observational data). The outcome measures varied considerably, but most included graft patency at varying levels of the follow-up. The randomized data showed strong evidence favouring the SVG, mainly in terms of mid-term patency. With the exception of a large cohort study that demonstrated the superior patency of the RITA compared with the SVG in the right coronary territory, the observational studies showed better results for SVG in graft patency, reintervention and cardiovascular complication rate. Overall, and in view of the methodological limitations and the different weight of evide...Continue Reading

References

Jan 17, 2004·The Annals of Thoracic Surgery·James TatoulisJohn A Fuller
Feb 1, 2005·The Annals of Thoracic Surgery·Dmitry PevniRephael Mohr
Apr 26, 2005·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Pallav J ShahBrian F Buxton
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Joel DunningKevin Mackway-Jones
Feb 23, 2010·The Annals of Thoracic Surgery·Gijong YiKyung-Jong Yoo

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Citations

Jul 18, 2012·Interactive Cardiovascular and Thoracic Surgery·Jamil Hajj-ChahinePierre Corbi
Aug 2, 2012·Interactive Cardiovascular and Thoracic Surgery·Dayal MukherjeeThanos Athanasiou
May 15, 2015·Asian Cardiovascular & Thoracic Annals·Haralabos ParissisBassel Al-Alao
May 15, 2015·Asian Cardiovascular & Thoracic Annals·Giovanni SaeedJörg Neuzner
Feb 3, 2019·The Journal of Thoracic and Cardiovascular Surgery·Harold L Lazar

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