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Bilateral internal mammary arteries are enough for total coronary revascularization

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Aim

Current evidence suggests arterial grafting improves freedom from cardiac events after coronary artery bypass graft surgery. We performed this study to determine if bilateral internal mammary artery grafts provide greater benefit than single internal mammary artery grafts.

Method

At our center, from January 2010 to January 2015, we performed 5842 CABG. Patients who got at least one arterial graft were included in this study (4952, 84.76%). Study population was divided into three groups. Group A-single internal mammary artery {SIMA (4571 patients)}, group B-bilateral internal mammary artery (BIMA) + third conduit (191 patients), and group C-BIMA (190 patients). On the basis of EuroSCORE, we selected 190 patients amongst group A-SIMA comparable to group B and group C.

Result

Groups had comparable risk profiles. There was no statistically difference between postoperative myocardial infarction (MI), postoperative atrial fibrillation, re-exploration, renal dysfunction, respiratory complications, superficial infection, deep sternal infection, and 30-day mortality amongst the three groups. However, early neurological complication rates were significantly lower in group B-1 (0.5%) and in group C-1 (0.5%) p value 0.017.

Conclusion

The use of bilateral internal mammary artery grafts resulted in significantly lower risk of early postoperative complications compared with single internal mammary artery, which in turn was superior to the use of vein grafts.

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Authors and Affiliations

  1. CTVS, Fortis Escorts Hospital, Okhla Road, New Delhi, Delhi, 110025, India

    Lalitaditya Malik, Jatin Yadav, Syed Asrar Qadri & Yugal Kumar Mishra

Authors
  1. Lalitaditya Malik
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  2. Jatin Yadav
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  3. Syed Asrar Qadri
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  4. Yugal Kumar Mishra
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Correspondence to Lalitaditya Malik.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. No animal was involved in this study.

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This study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

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Malik, L., Yadav, J., Qadri, S.A. et al. Bilateral internal mammary arteries are enough for total coronary revascularization. Indian J Thorac Cardiovasc Surg 33, 291–295 (2017). https://doi.org/10.1007/s12055-017-0575-1

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  • DOI: https://doi.org/10.1007/s12055-017-0575-1

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