Does it make sense to use two internal thoracic arteries?

Does it make sense to use two internal thoracic arteries?

Retrospectively, the first 143 patients who were operated on with bilateral internal thoracic arteries (BITA group) were matched with 143 patients operated on with only one left internal thoracic artery anastomosed on the left anterior descending artery and additional vein grafts (LITA group) and fo...

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Published in:The Annals of thoracic surgery Vol. 59; no. 6; pp. 1456 - 1463
Main Authors: Berreklouw, Eric, Schönberger, Jacques P.A.M., Ercan, Hüsamettin, Koldewijn, Evert L., de Bock, Marcel, Verwaal, Victor J., van der Linden, Frits, van der Tweel, Ingeborg, Bavinck, Johannus H., Bredée, Johan J.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-06-1995
Elsevier Science
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Cause of Death
Coronary Artery Bypass - adverse effects
Coronary Artery Bypass - methods
Coronary heart disease
Disease-Free Survival
Female
Follow-Up Studies
Heart
Humans
Male
Medical sciences
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Sex Factors
Stroke Volume
Thoracic Arteries - transplantation
Human
Cardiovascular disease
Bilateral
Coronary heart disease
Survival
Result
Treatment
Aortocoronary
Bypass
Follow up study
Surgery
Unilateral
Internal mammary artery
Comparative study
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Summary:Retrospectively, the first 143 patients who were operated on with bilateral internal thoracic arteries (BITA group) were matched with 143 patients operated on with only one left internal thoracic artery anastomosed on the left anterior descending artery and additional vein grafts (LITA group) and followed up for a maximum of 8 years. At 5 years follow-up there were no significant differences in event-free survival between the groups. After 8 years, the overall survival was 96% and 92% (not significant [NS]), cardiac survival 99% and 97% (NS), angina-free cardiac survival 51% and 35% (NS), infarction-free cardiac survival 95% and 78% (NS), reintervention-free cardiac survival 87% and 88% (NS), and all cardiac event-free survival 49% and 31% (NS) for the BITA and LITA groups, respectively. The incidence of late pulmonary, wound, and other complications was comparable. Cox proportional hazards analysis showed that a higher left ventricular end-diastolic pressure and female sex were predictors of recurrent angina and late cardiac events. During this intermediate-term follow-up, the use of one or two internal thoracic arteries was of no value in predicting angina-free or cardiac event-free survival.
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ISSN:0003-4975
1552-6259
DOI:10.1016/0003-4975(95)00183-L