title: On-Pump versus Off-Pump Complete Arterial Revascularization Using Bilateral Internal Mammary Arteries and the T-Graft Technique: Clinical and Angiographic Results for 3,445 Patients in 13 Years of Follow-Up.
abstract: BACKGROUND
  This is an investigation of complete arterial coronary artery bypass grafting (CACABG) using bilateral internal mammary arteries (IMA) and the T-graft technique either on- or off-pump as a routine approach to treat coronary artery disease.
  
  
  METHODS
  Between January 2000 and December 2012, 3,445 patients underwent on-pump (n = 2,216) or off-pump (n = 1,229) CACABG. A 30-day follow-up was performed prospectively, a long-term follow-up by a questionnaire, and coronary angiography in selected patients.
  
  
  RESULTS
  End points at 30 days were death, myocardial infarction, stroke, repeat revascularization, renal replacement, reoperation, sternal wound infection and atrial fibrillation. FitzGibbon A patency rates were 89.8 vs. 91.4% (p = 0.464) with consecutive percutaneous coronary intervention in the grafted area of 1.8 vs. 1.1% (p = 0.693) on- vs. off-pump, and no reoperation in the grafted area in both groups.
  
  
  CONCLUSIONS
  CACABG by use of skeletonized bilateral IMA with the T-graft technique performed either on- or off-pump is a safe and effective approach.
authors.affiliation: Departments of Cardiac Surgery and Cardiology, Albertinen Cardiovascular Center, Hamburg, Germany.
authors.forename: Friedrich-Christian
authors.initials: FC
authors.lastname: Riess
authors.forename: Stefan
authors.initials: S
authors.lastname: Heller
authors.forename: Eva
authors.initials: E
authors.lastname: Cramer
authors.forename: Nizar
authors.initials: N
authors.lastname: Awwad
authors.forename: Wagma
authors.initials: W
authors.lastname: Amin
authors.forename: Lorenz
authors.initials: L
authors.lastname: Hansen
authors.forename: Claas
authors.initials: C
authors.lastname: Lehmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.forename: Jan
authors.initials: J
authors.lastname: Stripling
authors.forename: Stephan
authors.initials: S
authors.lastname: Winkel
authors.forename: Peter
authors.initials: P
authors.lastname: Kremer
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome