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Long-Term Outcomes of Coronary Artery Bypass Grafting Using an Internal Thoracic Artery versus a Radial Artery as a Second Arterial Graft.
Oda, Ryoma; Kajimoto, Kan; Yamamoto, Taira; Endo, Daisuke; Kinoshita, Takeshi; Amano, Atsushi; Tabata, Minoru.
Afiliación
  • Oda R; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
  • Kajimoto K; Department of Cardiovascular Surgery, Juntendo University School of Medicine Shizuoka Hospital, Izunokuni, Shizuoka, Japan.
  • Yamamoto T; Department of Cardiovascular Surgery, Juntendo University School of Medicine Nerima Hospital, Tokyo, Japan.
  • Endo D; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
  • Kinoshita T; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
  • Amano A; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
  • Tabata M; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Ann Thorac Cardiovasc Surg ; 30(1)2024.
Article en En | MEDLINE | ID: mdl-38684396
ABSTRACT

PURPOSE:

To compare the outcomes of left circumflex artery (LCx) revascularization using an internal thoracic artery (ITA) or radial artery (RA) as the second arterial graft.

METHODS:

Patients who underwent primary isolated coronary artery bypass grafting with left anterior descending artery revascularization using an ITA and LCx revascularization using another bilateral ITA (BITA group) or an RA (ITA-RA group) were included. All-cause mortality (primary endpoint), cardiac death, major adverse cardiac events, in-hospital death, and deep sternal wound infection (secondary endpoints) were evaluated.

RESULTS:

Among 790 patients (BITA, n = 548 (69%); ITA-RA, n = 242 (31%)), no significant difference in all-cause mortality between the groups was observed (hazard ratio (HR) 0.87; 95% confidence interval (CI) 0.67-1.12; p = 0.27) during follow-up (mean, 10 years). Multivariate analysis revealed that the BITA group exhibited significantly lower rates of long-term all-cause mortality (HR 0.63; 95% CI 0.48-0.84; p = 0.01). In the propensity-matched cohort (n = 480, 240 pairs), significantly fewer all-cause deaths occurred in the BITA group (HR 0.66; 95% CI 0.47-0.93; p = 0.02). There were no significant differences in secondary outcomes.

CONCLUSIONS:

When used as second grafts for LCx revascularization, ITA grafts may surpass RA grafts in reducing all-cause mortality 10 years postoperatively.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Mortalidad Hospitalaria / Arteria Radial / Anastomosis Interna Mamario-Coronaria / Arterias Mamarias Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Mortalidad Hospitalaria / Arteria Radial / Anastomosis Interna Mamario-Coronaria / Arterias Mamarias Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón