Benefit of bilateral over single internal mammary artery grafts for multiple coronary artery bypass grafting.
BACKGROUND
The aim of this study was to evaluate the performance of bilateral internal mammary artery (BIMA) grafts in isolated CABG.


RESULTS
Beginning in April 1985, elective primary multiple CABG for multivessel disease was performed in 1131 patients. The early and late results of 688 patients who received single internal mammary artery (SIMA) grafts and 443 patients who received BIMA grafts were compared (median follow-up, 6.15 years). Hospital mortality was not significantly different in the SIMA (0.9%) and BIMA (0.9%) groups. Graft patency was 97.3% in the BIMA group and 94.3% in the SIMA group (P<0.0001). The 7-year repeated CABG-free rate was significantly higher in the BIMA group (P=0.026). The 7-year new myocardial infarction-free rate in all patients tended to be higher in the BIMA group (P=0.06). The hazard ratio for all death or repeated CABG in patients with ejection fractions >0.4 and age <71 years was lower in the BIMA group (P=0.0499).


CONCLUSIONS
Our data suggest that the use of BIMA grafts in patients with in situ coronary artery anastomoses achieves a significantly higher repeated CABG-free rate in all patients compared with the use of SIMA.
Endo
M
M
Departments of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. ENDO@hij.twmu.ac.jp
Nishida
H
H
Tomizawa
Y
Y
Kasanuki
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000706:statistics & numerical data; D002648:Child; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D018572:Disease-Free Survival; D019074:Epigastric Arteries / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000637:transplantation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency