Bilateral Internal Thoracic Artery In Situ Versus Y-Composite Graftings: Long-term Outcomes

Suk Ho Sohn, Yeiwon Lee, Jae Woong Choi, Ho Young Hwang, Ki Bong Kim

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: We compared 10-year graft patency rates and long-term clinical outcomes after off-pump coronary artery bypass grafting using bilateral internal thoracic arteries (ITAs) as in situ grafts with those using bilateral ITAs as Y-composite grafts. Methods: Of 509 patients who underwent off-pump coronary artery bypass grafting using bilateral ITAs, bilateral ITAs were used as in situ grafts in 172 patients (group I) and as Y-composite grafts in 337 patients (group Y). A propensity score–matched analysis was used to match group I patients (n = 153) with group Y patients (n = 153). Ten-year angiographic patency rates and long-term clinical outcomes were compared. The follow-up data were complete in 99.2% of patients (505/509) with a median follow-up duration of 175 months. Results: Ten-year overall patency rates and patency rates for distal anastomoses using bilateral ITAs were 87.5% (356/407) and 89.2% (297/333), respectively, in the propensity score–matched groups. No differences in overall patency rates (groups I vs Y, 84.9% vs 89.5%, P = .277) and bilateral ITA patency rates (groups I vs Y, 86.5% vs 91.1%, P = .282) were found between the propensity score–matched groups. There were no differences in the overall survival and cumulative incidence of cardiac death between the propensity score–matched groups (P = .312 and P = .812, respectively) up to 15 years after surgery. Cumulative incidences of target vessel revascularization (P = .606), reintervention (P = .849), and major adverse cardiac events (P = .672) were also similar between the propensity score–matched groups up to 15 years after surgery. Conclusions: Off-pump coronary artery bypass grafting using bilateral ITAs as in situ versus Y-composite grafts demonstrated no differences in terms of 10-year patency rates and long-term clinical outcomes between the groups.

Original languageEnglish
Pages (from-to)1773-1780
Number of pages8
JournalAnnals of Thoracic Surgery
Volume109
Issue number6
DOIs
StatePublished - Jun 2020

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