Saphenous Vein versus Arterial Graft to the Right System in Left-sided Arterial Revascularization.
The Annals of Thoracic Surgery(2021)
摘要
Abstract Background To investigate clinical outcomes of various arterial grafts (AGs) vs. saphenous vein grafts (VGs) to the right coronary system in patients who received left-side bilateral internal thoracic artery revascularization. Methods We compared short- and long-term outcomes of all the patients operated in our center during 1996-2011, who received left-sided bilateral internal thoracic artery (left anterior descending and left circumflex) grafting and either a VG or an AG to the right coronary system. Results Of 1691 patients, 983 received a VG and 708 received an AG to the right coronary system: 387 gastroepiploic arteries and 321 internal thoracic artery grafts. The median follow-up was 15.7 ± 0.32 years. For the VG and AG groups, early mortality (1.6% for VG and 1.3% for AG, p=0.55) and other early adverse outcomes did not differ. Long-term (up to 20 years) survival was similar (34.1 +/- 3.4% for VG vs. 36.0 +/-2% for AG, p=0.86). In multivariable analysis, VG to the right coronary artery was not found to be a predictor of inferior survival (hazard ratio: 0.99 95%CI 0.836-1.194, p=0.99). Comparing two propensity matched groups of 349 pairs with a VG or an AG, and accounting for the severity of the right coronary lesion, did not demonstrate differences in early outcome or late survival between the groups. Conclusions Early outcomes and long-term survival were comparable among patients who received left-sided bilateral internal thoracic artery revascularization, between various graft types to the right coronary system.
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