One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial.
OBJECTIVE
To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR).


RESULTS
We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional revascularization (CR) using left ITA and vein grafts. The primary angiographic outcome was the patency index: number of patent grafts (<50% stenosed) divided by number of constructed grafts. One-year angiography was complete for 83% of patients. Mean patency index (+/-SD) was 87 +/- 22% in the TAR group and 88 +/- 18% in the conventional group (P = 0.52). In 72% of TAR patients and 67% of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23%) TAR patients and 43 (25%) conventional group patients suffered cardiac events (HR 1.09, 95% CI 0.70-1.69, P = 0.70). One patient (0.6%) in the TAR group and two (1.2%) in the conventional group died (P = 1.00).


CONCLUSIONS
Within 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained or superior results of TAR can justify a more general use.
Damgaard
Sune
S
Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. sunedamgaard@dadlnet.dk
Wetterslev
Jørn
J
Lund
Jens T
JT
Lilleør
Nikolaj B
NB
Perko
Mario J
MJ
Kelbaek
Henning
H
Madsen
Jan K
JK
Steinbrüchel
Daniel A
DA
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D023921:Coronary Stenosis / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014654:Vascular Patency