Are three arteries better than two

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Presentation transcript:

Are three arteries better than two Are three arteries better than two? Impact of using the radial artery in addition to bilateral internal thoracic artery grafting on long-term survival Umberto Benedetto, MD, PhD, Massimo Caputo, MD, Mustafa Zakkar, PhD, Alan Bryan, MD, Gianni D. Angelini, MD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 3, Pages 862-869.e2 (September 2016) DOI: 10.1016/j.jtcvs.2016.04.054 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Survival curve comparisons between the bilateral internal thoracic artery plus radial artery (BITA+RA) and bilateral internal thoracic artery plus saphenous vein (BITA+SV) groups in the overall matched samples (left) and with the bilateral internal thoracic artery plus radial artery subgroup with total arterial revascularization (no saphenous vein [SV]; right). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Survival curve comparisons between the bilateral internal thoracic artery plus radial artery (BITA+RA) and bilateral internal thoracic artery plus saphenous vein (BITA+SV) groups according to the third conduit target. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Survival curve comparisons between bilateral internal thoracic artery plus radial artery (BITA+RA) and bilateral internal thoracic artery plus saphenous vein (BITA+SV) groups according to bilateral internal thoracic artery (BITA) in situ configuration versus right internal thoracic artery (RITA) as free graft. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Survival probabilities comparison between bilateral internal thoracic artery plus radial artery (BITA+RA) and bilateral internal thoracic artery plus saphenous vein (BITA+SV) groups in a time-segmented, propensity score (PS)–adjusted analysis. HR, Hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Missing data rate for individual variables (left) and their combinations (right). BMI, Body mass index; OPCAB, off-pump coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; LMD, left main coronary artery disease; NYHA, New York Heart Association functional class; PVD, peripheral vascular disease; AF, atrial fibrillation; CCS, Canadian Cardiovascular Society class; MI, myocardial infarction; PCI, percutaneous coronary intervention; LV, left ventricular; RCA, right coronary artery; CX, circumflex coronary artery; DIA, diagonal coronary artery. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Survival curves in matched groups receiving RA or SV as conduit along with BITA grafting. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Technique for harvesting the saphenous vein. Video available at http://www.jtcvsonline.org/article/S0022-5223(16)30262-8/addons. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 862-869.e2DOI: (10.1016/j.jtcvs.2016.04.054) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions