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Revista argentina de cardiología
On-line version ISSN 1850-3748
Abstract
ESPINOZA, JUAN et al. Off-Pump Coronary Artery Bypass Graft Surgery with Bilateral Internal Mammary Arteries in Left Main Coronary Artery Disease. Is There Any Benefit in 10-Year Mortality?. Rev. argent. cardiol. [online]. 2022, vol.90, n.3, pp.181-187. Epub June 01, 2022. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.es.v90.i3.20517.
Background:
The randomized controlled trials comparing coronary artery bypass graft (CABG) surgery versus percutaneous coronary intervention (PCI) included all types of surgical techniques (on-pump and off-pump) and different conduits (arterial and venous). Is it reasonable to assume that all surgical techniques are equal in terms of late mortality?
Objectives:
The aim of this study was to evaluate whether off-pump CABG surgery using both mammary arteries provides additional benefit over conventional revascularization using single mammary artery in terms of long-term survival for left main coronary artery (LMCA) disease.
Methods:
We conducted a retrospective, observational and comparative study (n=723) adjusted for risk. A stratified analysis was performed according to the use of single internal thoracic artery (SITA, n=144) or bilateral internal thoracic arteries (BITA, n=579) analyzing survival at 10 years after the intervention.
Results:
Survival at 10 years was significantly higher in BITA group (79.0%±3.4% vs 67.0%±4.9%, log-rank test, p <0.01). This advantage was also observed in the risk-adjusted analysis (93.0%±4.6 vs 69.0%±5.7 respectively, p=0.03). The use of BITA was an independent predictor of 10-year survival (HR 0.57, 95% CI 0.37-0.87, p=0.01).
Conclusion:
The use of bilateral internal mammary arteries in patients with left main coronary artery disease undergoing off-pump coronary artery bypass grafting was associated with higher survival at 10 years.
Keywords : Coronary Artery Bypass, Off-Pump; Coronary Artery Disease; Coronary Artery Bypass; Mammary Arterie.