[Single versus bilateral internal thoracic artery grafts for multi vessel coronary artery bypass grafting: effects on mortality and event-free survival]

ABSTRACT

The issue of superiority of single internal thoracic artery grafting versus bilateral internal thoracic artery grafting remains unresolved. The aim of this study was to compare the early results and midterm outcome of single and bilateral internal thoracic artery grafting for multivessel coronary artery bypass grafting. Between January 2005 and March 2010, 196 patients underwent primary coronary artery bypass grafting with at least one internal thoracic artery grafts. Early results and Outcomes of patients undergoing single internal thoracic artery [SIMA] plus saphenous vein grafting [n=145] and bilateral internal thoracic artery [BIMA] plus saphenous vein grafting [n=51] were obtained at a mean follow up of 29 months. Patients with bilateral internal thoracic artery grafting were younger, had less hypertension, higher left main disease and better Euroscore than patients undergoing single internal thoracic artery grafting. In-hospital mortality was similar for the two groups 6.9% for patients undergoing SIMA versus 5.9% for those undergoing BIMA [p=0.8]. Sternal wound infection was also similar [2.8% versus 3.9% p=0.68]. Mid-term mortality was [4% VS 4.8% p=0.71] and event free survival probability at 28 months was 75% for the single-graft group compared with 85.7% for the bilateral-graft group [P =0.46]. Our study found similar early and mid-term clinical outcomes for patients undergoing SIMA plus saphenous vein grafting and those undergoing BIMA plus saphenous vein grafting for multivessel coronary artery bypass grafting