Key result
Total arterial revascularization using multiple arterial conduits is a feasible and desirable objective that offers biologic advantages over traditional saphenous vein grafts.
Why the study?
Does total arterial revascularization improve long-term survival compared to traditional saphenous vein grafts in patients undergoing coronary bypass surgery?
Does total arterial revascularization improve long-term survival compared to traditional saphenous vein grafts in patients undergoing coronary bypass surgery?
Total arterial revascularization using various arterial conduits is advocated as a biologically superior alternative to traditional saphenous vein grafts for coronary bypass surgery.
May warrant arterial conduit strategies in suitable CABG patients; leaves open need for RCTs to confirm survival benefits.
The impact of left internal mammary to left anterior descending coronary bypass grafting in enhancing long-term patient survival has led to a widespread interest in arterial grafting over the past decade. It is now accepted that the internal mammary artery is a biologically superior coronary bypass graft compared with the traditional saphenous vein. Experience with other arterial grafts--the right gastro-epiploic artery, the inferior epigastric artery and the radial artery--has shown compelling evidence that they share the same biologic advantage. With the judicious use of some or all of these conduits, all regions of the heart can be reached, and total arterial revascularization is a feasible and desirable objective on a routine basis. As long-term results become available, it is inevitable that it will become the operation of choice.
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Pym et al. (1997) conducted a review in Coronary artery disease requiring bypass grafting. Total arterial revascularization vs. Traditional saphenous vein grafting was evaluated. Total arterial revascularization using multiple arterial conduits is a feasible and desirable objective that offers biologic advantages over traditional saphenous vein grafts.
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