Journal Article

Randomized Trial of Bilateral versus Single Internal-Thoracic-Artery Grafts

Benedetto, Umberto, Taggart, David P, Gerry, Stephen, Lees, Belinda, Altman, Douglas G, Gray, Alastair M, Flather, Marcus

2016

Overview

In this trial, over 3000 patients undergoing CABG were assigned to single or bilateral internal-thoracic-artery grafts. At 5 years, there was no difference in mortality or cardiovascular events. More sternal wound infections occurred with bilateral grafts. Coronary-artery bypass grafting (CABG) is one of the most commonly performed operations worldwide and has been established as an effective treatment for symptomatic multivessel coronary artery disease. 1 , 2 The standard surgical approach is anastomosis of the left internal thoracic (mammary) artery to the left anterior descending coronary artery and the use of saphenous-vein or radial-artery grafts to bypass other coronary arteries. 3 , 4 The single internal-thoracic-artery graft has a 10-year rate of angiographic patency exceeding 90%, as compared with 50% for vein grafts. 5 – 10 The excellent long-term outcomes of single internal-thoracic-artery grafts 11 , 12 have stimulated the use of a bilateral internal-thoracic-artery . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Bypass / Cardiovascular disease / Cause of Death / Cerebral infarction / Clinical outcomes / Clinical trials / Coronary artery / Coronary Artery Bypass - methods / Coronary Artery Disease - mortality / Coronary Artery Disease - surgery / Coronary vessels / Death / Evidence-based medicine / Female / Follow-Up Studies / Heart / Heart surgery / Humans / Incidence / Male / Mammary Arteries - transplantation / Middle Aged / Myocardial infarction / Myocardial Infarction - epidemiology / Skin & tissue grafts / Stents / Stroke - epidemiology / Survival Rate / Thorax / Wounds