title: Outcomes in single versus bilateral internal thoracic artery grafting in coronary artery bypass surgery.
abstract: The authors analyzed the early outcomes in two groups of patients undergoing coronary artery bypass grafting (CABG) with single versus bilateral internal thoracic arteries (ITA) in their institution. One thousand sixty-nine patients underwent CABG with single or bilateral ITAs from 1990 to 2000. Of these patients, 911 (85.2%) had single ITA and 158 had bilateral ITA (14.8%). The incidence of tobacco abuse was 40.3% in the single ITA group and 56.7% in the double ITA group (P = 0.0001). The incidence of perioperative myocardial infarction, renal failure, reoperation for bleeding, stroke, or operative mortality did not differ in the two groups. There was a 4.4% incidence of mediastinitis in the bilateral ITA group versus 2.2% in the single ITA group (P = 0.0602). Early outcomes after bilateral ITA grafting for CABG are similar to single ITA grafting. Careful judgment should be exercised in selecting patients for bilateral ITA grafting, particularly if the patient smokes.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Jon-Cecil M
authors.initials: JC
authors.lastname: Walkes
authors.forename: Nan
authors.initials: N
authors.lastname: Earle
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Reardon
authors.forename: Donald H
authors.initials: DH
authors.lastname: Glaeser
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Wall
authors.forename: Joseph
authors.initials: J
authors.lastname: Huh
authors.forename: James W
authors.initials: JW
authors.lastname: Jones
authors.forename: Ernesto R
authors.initials: ER
authors.lastname: Soltero
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008480:Mediastinitis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology / Q000601:surgery