Long-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting?

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Date of download: 6/3/2016 Copyright © The American College of Cardiology. All rights reserved. From: Survival of patients with diabetes and multivessel.

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Presentation transcript:

Long-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting? Dmitry Pevni, MD, Rephael Mohr, MD, Yosef Paz, MD, Amir Kramer, MD, Yanai Ben-Gal, MD, Nahum Nesher, MD, Benjamin Medalion, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 5, Pages 1311-1319 (May 2016) DOI: 10.1016/j.jtcvs.2015.12.005 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Composite T-graft with radial artery attached end-to-side to the left internal mammary artery. AO, Aorta; LITA, left interior mammary artery; PA, pulmonary artery; RA, radial artery; D, descending; PDA, pulmonary descending artery; M, main; LAD, left anterior descending. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1311-1319DOI: (10.1016/j.jtcvs.2015.12.005) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Kaplan–Meier survival curves of patients in the group treated with BIMA grafting and those in the group treated with single IMA + RA grafting, before matching. Values in rows below graph indicate numbers of patients receiving each treatment at corresponding number of years. BIMA, Bilateral internal mammary artery. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1311-1319DOI: (10.1016/j.jtcvs.2015.12.005) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Standardized differences plot (BIMA vs SIMA + RA). NIDDM, Non–insulin-dependent diabetes mellitus; IDDM, insulin-dependent diabetes mellitus; DM, diabetes mellitus; EOD, end organ damage; PVD, peripheral vascular disease; COPD, chronic obstructive pulmonary disease; CHF, congestive heart failure; CRF, chronic renal failure; Cr, creatine; MI, myocardial infarction; EF, ejection fraction; Preop., preoperative; IABP, intra-aortic balloon pump; op., operation; s/p PCI, status post percutaneous coronary intervention; LM, left main; 3 VD, 3-vessel disease; BIMA, bilateral internal mammary artery; SIMA, single internal mammary artery. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1311-1319DOI: (10.1016/j.jtcvs.2015.12.005) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Survival of the groups treated with BIMA grafting and single IMA + RA grafting, after propensity-score matching. Values in rows below graph indicate numbers of patients receiving each treatment at corresponding number of years. SIMA, Single internal mammary artery; BIMA, bilateral internal mammary artery. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1311-1319DOI: (10.1016/j.jtcvs.2015.12.005) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Survival of the groups treated with BIMA grafting and with single IMA + RA grafting, after propensity-score matching. Long-term survival of patients undergoing composite T-grafting with single, left, IMA and RA is not inferior to that with BIMA grafting. Values in rows below graph indicate numbers of patients receiving each treatment at corresponding number of years. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1311-1319DOI: (10.1016/j.jtcvs.2015.12.005) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions