Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial.
OBJECTIVE
The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse.


METHODS
In a randomized single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up.


RESULTS
The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0.9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound complications requiring hospitalization: 3 (1.9%) versus 6 (3.5%) (P = .50), respectively.


CONCLUSIONS
These results confirm previous reports that total arterial revascularization can be performed with low in-hospital morbidity and mortality. Further, in the 3 postoperative months, total arterial revascularization did not lead to more complications or admissions than conventional surgery. Arterial grafting was performed with significantly fewer bypasses, but no differences in anginal status were seen after 3 months. A tendency toward more sternal complications after arterial grafting was observed, but clinical outcomes were comparable to conventional grafting.
Damgaard
Sune
S
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark. sunedamgaard@dadlnet.dk
Lund
Jens T
JT
Lilleør
Nikolaj B
NB
Perko
Mario J
MJ
Sander
Kåre
K
Dimo
Blagoja
B
Jensen
Maiken B
MB
Madsen
Jan K
JK
Kelbaek
Henning
H
Steinbrüchel
Daniel A
DA
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation; D016896:Treatment Outcome