Use Rate and Outcome in Bilateral Internal Thoracic Artery Grafting: Insights From a Systematic Review and Meta-Analysis

Journal of the American Heart Association
Mario GaudinoStephen E Fremes

Abstract

This meta-analysis was designed to assess whether center experience affects the short- and long-term results and the relative benefits of bilateral internal thoracic artery grafting (BITA) for coronary artery bypass grafting. MEDLINE and EMBASE were searched to identify all articles reporting the outcome of BITA in patients undergoing coronary artery bypass grafting. The BITA center experience was gauged according to the percentage use of BITA in the institutional overall coronary artery bypass grafting population (%BITA). The primary outcome was long-term all-cause mortality. Secondary outcomes were operative mortality, perioperative myocardial infarction, perioperative stroke, deep sternal wound infections (DSWIs), and major postoperative adverse event. The rates of the primary and secondary outcomes were calculated after adjusting for %BITA. Primary and secondary outcomes were also compared between the BITA and the single internal thoracic artery arms in the adjusted studies. Meta-regression was used to evaluate the effect of %BITA on the primary and secondary outcomes. Thirty-four studies (27 894 patients undergoing BITA) were included. In the pooled analysis, the incidence rate for long-term mortality was 2.83% (95% confid...Continue Reading

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Jan 31, 2019·The New England Journal of Medicine·Stuart J Head, Arie P Kappetein
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Dec 15, 2020·The Journal of Thoracic and Cardiovascular Surgery·Mario GaudinoStephen Fremes
Sep 4, 2021·Current Opinion in Cardiology·N Bryce RobinsonMario Gaudino

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

Comprehensive Meta Analysis
MOOSE
GetData Graph Digitizer
R
BITA
meta
metafor
R Project for Statistical Computing

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