Key result
Bilateral internal thoracic artery grafting is associated with improved long-term survival compared to single internal thoracic artery grafting, though it carries an increased risk of sternal wound infections.
Why the study?
Does bilateral internal thoracic artery (BITA) grafting improve survival compared to single internal thoracic artery grafting in patients with coronary artery disease undergoing CABG?
Does bilateral internal thoracic artery (BITA) grafting improve survival compared to single internal thoracic artery grafting in patients with coronary artery disease undergoing CABG?
Bilateral internal thoracic artery grafting during CABG appears to offer a long-term survival benefit for patients up to approximately 69 years of age, though it is associated with a higher risk of sternal wound infections.
Supports BITA consideration to age 69 with infection caution; leaves open randomized confirmation before practice change.
PURPOSE OF REVIEW: Several advances have been made in recent years to improve outcome for patients with coronary artery disease. One of the most debated topics regarding surgical treatment with coronary artery bypass grafting (CABG) is graft selection. This review aims to present the current status and scientific evidence for bilateral internal thoracic artery (BITA) grafting. RECENT FINDINGS: Observational studies and pooled analyses suggest that BITA grafting is associated with improved survival. Early results from a large randomized controlled trial report safety and efficacy of the method. The improved survival might be amplified in select groups, but with an increase in sternal wound-related complications. The benefit of BITA grafts seems to remain to an approximate age of 69 years at surgery. CABG with BITA grafts is likely associated with improved long-term survival at a cost of an increase in sternal wound infections. Ten-year results from the Arterial Revascularization Trial are expected in 2018, providing the best evidence regarding the method yet. Early results show it is a safe method in most patient categories considerable for CABG.
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Persson et al. (2018) conducted a review in Coronary artery disease. Bilateral internal thoracic artery (BITA) grafting vs. Single internal thoracic artery (SITA) grafting was evaluated on Long-term survival. Bilateral internal thoracic artery grafting is associated with improved long-term survival compared to single internal thoracic artery grafting, though it carries an increased risk of sternal wound infections.
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