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Total arterial grafting is associated with improved clinical outcomes compared to conventional myocardial revascularization at 10 years follow-up

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Abstract

The use of arterial conduits is associated with incremental benefits when compared to conventional CABG surgery, albeit there is a paucity of data regarding the long-term outcomes of either techniques. Among 973 consecutive patients undergoing CABG, a propensity-match study was performed to compare total arterial revascularization technique (G1) with a conventional approach (LITA on LAD plus additional SVGs, G2). The study population was propensity-matched based on preoperative characteristics (age, sex, risk factors). Mean number of grafted vessels (G1 = 2.39 ± 0.55 vs G2 = 2.37 ± 0.7; p = 0.79) and aortic cross-clamp time (G1 = 36 ± 6 vs G2 = 35 ± 6 min; p = 0.31) were similar while CPB time was significantly longer in Group 2 (G1 = 50 ± 7 vs G2 = 70 ± 8 min; p = 0.03). Hospital mortality (G1 = 0.6 % vs G2 = 1.3 %; p = 0.41) and overall incidence of postoperative complications were also comparable. Cox regression analysis depicted conventional CABG as an independent predictor for MACCEs (HR = 4.53, CI 95 % = 2–10.28; p < 0.001). Median follow-up time was 112 months: actuarial survival free from cardiac death (G1 = 100 % vs G2 = 95 ± 2.1 %; p = 0.046) and MACCEs (G1 = 97.3 ± 1.5 % vs G2 = 79.4 ± 3.8 %; p < 0.001) was significantly improved in patients undergoing total arterial grafting. Total arterial myocardial revascularization is associated with significantly improved outcomes at 10 years follow-up in terms of cardiac-related mortality and overall event-free survival.

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Authors and Affiliations

  1. Division of Cardiac Surgery, University of Brescia Medical School, P.le Spedali Civili, 1, Brescia, 25123, Italy

    Gianluigi Bisleri, Lorenzo Di Bacco, Laura Giroletti & Claudio Muneretto

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  1. Gianluigi Bisleri
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  2. Lorenzo Di Bacco
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  3. Laura Giroletti
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  4. Claudio Muneretto
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Correspondence to Gianluigi Bisleri.

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Bisleri, G., Di Bacco, L., Giroletti, L. et al. Total arterial grafting is associated with improved clinical outcomes compared to conventional myocardial revascularization at 10 years follow-up. Heart Vessels 32, 109–116 (2017). https://doi.org/10.1007/s00380-016-0846-6

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