OBJECTIVE: Bilateral internal mammary artery (BIMA) grafting is associated with improved survival. However, many surgeons are reluctant to use this technique, owing to the potentially increased risk of sternal infection. The composite T-graft with @entity432 ( @entity432 ) attached end-to-side to the left internal mammary artery (IMA) provides complete arterial revascularization without increased risk of sternal infection. The purpose of this study is to compare outcomes of these 2 strategies. METHODS: @entity1 who underwent BIMA grafting using the composite T-graft technique, between 1996 and 2010 (n  =  1329), were compared with 389 @entity1 who underwent composite grafting with a single IMA  +  @entity432 during the same time period. RESULTS: @entity1 undergoing single IMA grafting were older, more often @entity1 , and more likely to have @entity6 , @entity1095 , and @entity1030 , and to need an emergency operation. @entity712 , @entity66 , and recent @entity583 were more prevalent with bilateral grafting. Propensity-score matching was used to account for differences between groups in preoperative @entity1 characteristics. The 268 matched pairs had similar characteristics. The median follow-up time was 14.19 (95% confidence interval 13.43-14.95) years. Operative mortality and Kaplan-Meier 10-year survival of the 2 matched groups were similar (3.4% vs 3.7%, and 61.6% vs 64%, for the groups treated with BIMA and single IMA, respectively). Cox-adjusted survival was similar (P  =  .514). Age, @entity177 , and performance of <3 bypass grafts were independent predictors of decreased survival. CONCLUSIONS: This study suggests that long-term outcomes of arterial revascularization with a composite T-graft constructed using left IMA and @entity432 are not inferior to outcomes after BIMA grafting.

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

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient'] @entity1095 :: ('MESH:D016491', 'Disease') :: ['peripheral vascular disease'] @entity712 :: ('MESH:D006333', 'Disease') :: ['Congestive heart failure'] @entity66 :: ('MESH:D004194', 'Disease') :: ['left main disease'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity177 :: ('MESH:D051437', 'Disease') :: ['chronic renal failure'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['COPD'] @entity432 :: ('MESH:D001157', 'Disease') :: ['RA', 'radial artery'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction']
@entity432 :: (MESH:D001157,Disease) :: ['radial artery']
