Long-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting?

The Journal of Thoracic and Cardiovascular Surgery
Dmitry PevniBenjamin Medalion

Abstract

Bilateral internal mammary artery (BIMA) grafting is associated with improved survival. However, many surgeons are reluctant to use this technique, owing to the potentially increased risk of sternal infection. The composite T-graft with radial artery (RA) attached end-to-side to the left internal mammary artery (IMA) provides complete arterial revascularization without increased risk of sternal infection. The purpose of this study is to compare outcomes of these 2 strategies. Patients who underwent BIMA grafting using the composite T-graft technique, between 1996 and 2010 (n = 1329), were compared with 389 patients who underwent composite grafting with a single IMA + RA during the same time period. Patients undergoing single IMA grafting were older, more often women, and more likely to have diabetes, peripheral vascular disease, and COPD, and to need an emergency operation. Congestive heart failure, left main disease, and recent myocardial infarction were more prevalent with bilateral grafting. Propensity-score matching was used to account for differences between groups in preoperative patient characteristics. The 268 matched pairs had similar characteristics. The median follow-up time was 14.19 (95% confidence interval 13.43-1...Continue Reading

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Citations

Jul 17, 2016·The Journal of Thoracic and Cardiovascular Surgery·Saswata Deb, Stephen E Fremes
Oct 5, 2016·The Journal of Thoracic and Cardiovascular Surgery·Umberto BenedettoGianni D Angelini
May 10, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nicola VistariniSiamak Mohammadi
Sep 1, 2021·The Journal of Thoracic and Cardiovascular Surgery·Francesco FormicaFrancesco Nicolini
Apr 20, 2020·The Journal of Thoracic and Cardiovascular Surgery·Mohamed MarzoukSiamak Mohammadi

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