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Abstract:

Objective: The aim of our study was to evaluate the long-term outcome of patients exclusively undergoing total arterial revascularization off-pump coronary artery bypass grafting and to compare the performance of the radial artery and the right internal thoracic artery as a second conduit. Methods: We studied a consecutive series of 1700 patients undergoing off-pump coronary artery bypass grafting, receiving a radial artery or right internal thoracic artery as a second graft for total arterial revascularization, between 2003 and 2010. A total of 1447 patients (85.11%) received bilateral internal thoracic artery grafting, and 253 patients (14.89%) received left internal thoracic artery and radial artery grafting. A propensity score-matched analysis was performed to compare the 2 groups, bilateral internal thoracic artery and left internal thoracic artery and radial artery, relative to overall survival, morbidity, and combined end points event-free survival. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were estimated by Cox regression. Results: In the full unmatched patient population, the postoperative survival (HR, 0.59; 95% CI, 0.38-0.92; P =.021), incidence of reintervention/readmission (HR, 0.42; 95% CI, 0.28-0.61; P <.001), and combined end points (HR, 0.47; 95% CI, 0.35-0.63; P <.001) were significantly better in the bilateral internal thoracic artery group. In the propensity score-matched patient population, the incidence of reintervention/readmission (HR, 0.40; 95% CI, 0.18-0.88; P =.02) and combined end points (HR, 0.54; 95% CI, 0.32-0.92; P =.02) were significantly better in the bilateral internal thoracic artery group compared with the left internal thoracic artery-radial artery group. Conclusions: The results of our study provide evidence for the superiority of the right internal thoracic artery graft compared with the radial artery as a second conduit in total arterial revascularization off-pump coronary artery bypass grafting. Copyright © 2014 by The American Association for Thoracic Surgery.

Registro:

Documento: Artículo
Título:Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study
Autor:Navia, D.; Vrancic, M.; Piccinini, F.; Camporrotondo, M.; Thierer, J.; Gil, C.; Benzadon, M.
Filiación:Cardiac Surgery Service, Instituto Cardiovascular de Buenos Aires, Blanco Encalada 1543, 1428 Ciudad de Buenos Aires, Buenos Aires, Argentina
Palabras clave:adult; aged; artery graft; article; assisted ventilation; cardiac conduit; cardiovascular mortality; cerebrovascular accident; comparative study; controlled study; event free survival; female; follow up; forward heart failure; heart left ventricle failure; hospital readmission; human; incidence; internal mammary artery; kidney dysfunction; left internal thoracic artery; major clinical study; male; middle aged; morbidity; off pump coronary surgery; outcome assessment; overall survival; postoperative complication; priority journal; propensity score; radial artery; retrospective study; revascularization; right coronary artery; right internal thoracic artery; surgical mortality; survival; total arterial revascularization; 23; bilateral internal thoracic artery; BITA; CABG; CI; confidence interval; coronary artery bypass grafting; European System for Cardiac Operative Risk Evaluation; euroSCORE; hazard ratio; HR; internal thoracic artery; interquartile range; IQR; ITA; LAD; left anterior descending; left internal thoracic artery; LITA; odds ratio; off-pump coronary artery bypass; OPCAB; OR; RA; radial artery; right internal thoracic artery; RITA; saphenous vein graft; SVG; TAR; total arterial revascularization; Aged; Chi-Square Distribution; Coronary Artery Bypass, Off-Pump; Disease-Free Survival; Female; Follow-Up Studies; Humans; Internal Mammary-Coronary Artery Anastomosis; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Patient Readmission; Postoperative Complications; Propensity Score; Proportional Hazards Models; Radial Artery; Reoperation; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
Año:2014
Volumen:147
Número:2
Página de inicio:632
Página de fin:638
DOI: http://dx.doi.org/10.1016/j.jtcvs.2013.02.012
Título revista:Journal of Thoracic and Cardiovascular Surgery
Título revista abreviado:J. Thorac. Cardiovasc. Surg.
ISSN:00225223
CODEN:JTCSA
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00225223_v147_n2_p632_Navia

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Citas:

---------- APA ----------
Navia, D., Vrancic, M., Piccinini, F., Camporrotondo, M., Thierer, J., Gil, C. & Benzadon, M. (2014) . Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study. Journal of Thoracic and Cardiovascular Surgery, 147(2), 632-638.
http://dx.doi.org/10.1016/j.jtcvs.2013.02.012
---------- CHICAGO ----------
Navia, D., Vrancic, M., Piccinini, F., Camporrotondo, M., Thierer, J., Gil, C., et al. "Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study" . Journal of Thoracic and Cardiovascular Surgery 147, no. 2 (2014) : 632-638.
http://dx.doi.org/10.1016/j.jtcvs.2013.02.012
---------- MLA ----------
Navia, D., Vrancic, M., Piccinini, F., Camporrotondo, M., Thierer, J., Gil, C., et al. "Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study" . Journal of Thoracic and Cardiovascular Surgery, vol. 147, no. 2, 2014, pp. 632-638.
http://dx.doi.org/10.1016/j.jtcvs.2013.02.012
---------- VANCOUVER ----------
Navia, D., Vrancic, M., Piccinini, F., Camporrotondo, M., Thierer, J., Gil, C., et al. Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study. J. Thorac. Cardiovasc. Surg. 2014;147(2):632-638.
http://dx.doi.org/10.1016/j.jtcvs.2013.02.012