Document Detail


Excellent long-term clinical outcome after coronary artery bypass surgery using three pedicled arterial grafts in patients with three-vessel disease.
MedLine Citation:
PMID:  18222253     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Long-term clinical outcome of complete arterial grafting in three-vessel disease is unknown. METHODS: We studied 344 patients who underwent complete arterial revascularization using the internal thoracic arteries and the right gastroepiploic artery. Freedom from major adverse cardiac events (MACE) was evaluated by the Kaplan-Meier method, and homogeneity of outcome in strata of patients was assessed using Cox proportional hazards modeling. RESULTS: Median follow-up of survivors was 9.3 years (range, 0.01 to 12.8 years). The 12-year freedom from MACE was 75.5%. For the composite of MACE, this was 86.9% for cardiovascular death, 93.3% for myocardial infarction, and 89.4% for reintervention. In patients aged older than 65 years, MACE occurred significantly more frequent, with a freedom from MACE of 65.8% compared with 82.6% in younger patients (hazard ratio, 3.4; 95% confidence interval, 2.1 to 5.6, p < 0.001). CONCLUSIONS: Complete arterial revascularization using both pedicled internal thoracic arteries and the gastroepiploic artery in patients with three-vessel disease resulted in an excellent long-term clinical outcome, especially in patients aged younger than 65 years.
Authors:
Nic J G M Veeger; Gerald F Panday; Adriaan A Voors; Jan G Grandjean; Jan van der Meer; Piet W Boonstra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  508-12     Citation Subset:  AIM; IM    
Affiliation:
Thoraxcenter, Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Coronary Angiography
Coronary Artery Bypass / methods*,  mortality
Coronary Restenosis / epidemiology
Coronary Stenosis / mortality,  pathology*,  radiography,  surgery*
Female
Follow-Up Studies
Gastroepiploic Artery / transplantation*
Graft Rejection
Graft Survival
Humans
Male
Mammary Arteries / transplantation*
Middle Aged
Postoperative Complications / epidemiology
Probability
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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