title: Bilateral internal thoracic artery in situ versus y-composite graftings: five-year angiographic patency and long-term clinical outcomes.
abstract: BACKGROUND
  We compared 5-year graft patency rates and long-term clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) using bilateral internal thoracic arteries (ITAs) as in situ grafts with those using bilateral ITAs as a Y-composite graft.
  
  
  METHODS
  Of 398 patients who underwent OPCAB, bilateral ITAs were used as in situ grafts in 164 patients and as a Y-composite graft in 234 patients. A propensity score-matched analysis was used to match patients using bilateral ITA in situ grafts (group I, n=110) with patients using bilateral ITA Y-composite grafts (group Y, n=110). Postoperative early, 1-year, and 5-year angiographic patency rates and long-term clinical outcomes during follow-up of 104 (1 to 149) months were compared.
  
  
  RESULTS
  There were no differences in operative mortalities (2 of 110 vs 1 of 110; p>0.999) and postoperative complications between groups I and Y. Early, 1-year, and 5-year postoperative angiographies showed no significant differences in bilateral ITA graft patency rates between groups I and Y (early, 98.2% vs 99.3%, p=0.450; 1-year, 92.5% vs 95.7%, p=0.138; 5-year, 92.5% vs 92.4%, p=0.978). No differences in overall survival (p=0.347) and freedom from cardiac death (p=0.780) rates were observed between the groups; 10-year freedom from cardiac death rates were 95.1% and 94.2% in groups I and Y, respectively. Reintervention-free survival (p=0.379) and major adverse cardiac event-free survival (p=0.338) rates were also similar between the groups.
  
  
  CONCLUSIONS
  The OPCAB using both bilateral ITA configurations demonstrated that there were no differences in terms of 5-year patency rates and long-term clinical outcomes between the groups.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.forename: Jun Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Kwang Ree
authors.initials: KR
authors.lastname: Cho
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000368:Aged; D001158:Arteries / Q000637:transplantation*; D002423:Cause of Death; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000401:mortality; D015996:Survival Rate; D014654:Vascular Patency / Q000502:physiology; D014680:Veins / Q000637:transplantation*