Document Detail

Long-term results of multiple arterial bypass conduits.
MedLine Citation:
PMID:  25286374     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: Ongoing efforts to compare percutaneous coronary intervention with coronary bypass surgery for multivessel coronary disease mandate that surgeons reevaluate best practices for coronary surgery in order to maximize long-term outcomes. This review presents recent data for the long-term outcomes of multiple arterial grafting in terms of patient selection, conduit choice, and technical considerations.
RECENT FINDINGS: Multiple arterial grafting remains poorly utilized, with fewer than 10% of cases receiving more than one arterial graft. Bilateral internal thoracic artery grafting confers superior long-term survival and freedom from reoperation over single thoracic artery with saphenous vein. Use of a second internal thoracic artery graft is advantageous in diabetic patients despite higher risk of sternal wound complications. Routine use of skeletonized grafts and Y or T grafting to allow complete revascularization allows lower early complication rates and better long-term survival. Radial artery grafts confer superior long-term survival compared with saphenous vein grafts and should be considered in patients at high risk for sternal wound complications.
SUMMARY: Multiple arterial grafting confers superior long-term outcomes in comparison with single internal thoracic artery grafting and should be considered as the standard of care.
Douglas R Johnston
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  29     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-10-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  542-6     Citation Subset:  IM    
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