title: Are two internal thoracic artery grafts as safe as one? Experience from Green Lane Hospital.
abstract: OBJECTIVE
  To compare short-term mortality and major morbidity between patients undergoing elective primary isolated CABG with bilateral internal thoracic artery (BITA) or single internal thoracic artery (SITA) grafts at Green Lane Hospital (Auckland, New Zealand).
  
  
  METHODS
  We conducted a retrospective study of short-term outcomes in 5955 patients receiving SITA and 637 patients receiving BITA grafts between 1990 and 2004. Only patients undergoing elective primary isolated coronary artery surgery were included. The primary outcome was a composite end-point (early death, perioperative MI, reoperation for sternal wound complications or significantly prolonged hospital stay). Patients receiving BITA grafts were case-matched with patients receiving SITA grafts for confounding factors and comparison was made between perioperative outcomes in the two groups.
  
  
  RESULTS
  After case-matching, no statistically significant difference was found in the incidence of our primary endpoint between patients receiving BITA versus SITA grafts [odds ratio 0.84 (95% CI 0.59, 1.21)]. Furthermore, there was no difference in rates of reoperation for sternal wound complications between the two groups [odds ratio 1.00 (95% CI 0.29, 3.44)].
  
  
  CONCLUSIONS
  Given the potential long-term clinical advantages of BITA grafting, our results support the increased use of BITA grafts in selected patients.
authors.affiliation: Department of General Medicine, Auckland City Hospital, Auckland. New Zealand.
authors.forename: Arul
authors.initials: A
authors.lastname: Baradi
authors.forename: Paget F
authors.initials: PF
authors.lastname: Milsom
authors.forename: Alan F
authors.initials: AF
authors.lastname: Merry
authors.forename: Lynnette R
authors.initials: LR
authors.lastname: Ferguson
mesh_terms: D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D009017:Morbidity; D009520:New Zealand; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome