| Off-pump Bilateral Skeletonized Internal Thoracic Artery Grafting in Elderly Patients. | |
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MedLine Citation:
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PMID: 22197616 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of the present study was to compare outcome in propensity score-matched patients, aged 70 years or greater, undergoing isolated off-pump coronary bypass surgery using a bilateral (BITA) or single (SITA) skeletonized internal thoracic artery. METHODS: Of 912 consecutive patients undergoing isolated coronary bypass grafting (906 using the off-pump technique without emergent conversion to cardiopulmonary bypass), the 491 aged 70 years or greater undergoing off-pump skeletonized single (n = 247) or bilateral (n = 244) skeletonized internal thoracic artery grafting were retrospectively analyzed after excluding the 6 who were transferred to our hospital after receiving percutaneous cardiopulmonary bypass, the 72 who had only 1 target in the left coronary area, and the 343 aged less than 70 years. A total of 217 pairs were matched using propensity scores calculated from 9 preoperative factors (0.69). RESULTS: The rate of postoperative complications was similar between the groups. The 5-year estimated survival free from overall death and cardiac event, respectively, in the BITA group versus the SITA group were 86.4% ± 3.2% versus 73.5% ± 3.9% (p = 0.01) and 93.2% ± 2.7% versus 87.5% ± 3.0% (p = 0.01). In multivariate Cox models, bilateral internal thoracic artery grafting was significantly associated with a lower risk of overall death (hazard ratio 0.56; 95% confidence interval 0.31 to 0.99; p = 0.04) and cardiac event (hazard ratio 0.36; 95% confidence interval 0.15 to 0.88; p = 0.03). CONCLUSIONS: In elderly patients, off-pump in situ left-sided bilateral skeletonized internal thoracic artery grafting is associated with lower risk of overall death and cardiac event than single internal thoracic artery grafting and carries no increased operative risk. |
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Authors:
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Takeshi Kinoshita; Tohru Asai; Tomoaki Suzuki; Satoshi Kuroyanagi; Soh Hosoba; Noriyuki Takashima |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-23 |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: - ISSN: 1552-6259 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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