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Prevalence and variability of internal mammary graft use in contemporary multivessel coronary artery bypass graft.
MedLine Citation:
PMID:  20881486     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To assess the current status of the prevalence and variability of internal mammary graft use in contemporary multivessel coronary artery bypass graft (CABG).
RECENT FINDINGS: The internal mammary artery (IMA) is considered the gold-standard conduit in coronary artery bypass graft (CABG) surgery. There is universal agreement that the IMA graft is associated with significantly improved short-term and long-term survival in CABG and the use of the IMA is recognized as a key performance measure world wide. In the recently developed Society of Thoracic Surgeons (STS) composite measure for CABG, use of an IMA was found to be the only intra-operative performance measure associated with quality of care. Furthermore, several studies have shown that bilateral IMA (BIMA) use improves long-term outcome compared with single IMA use. An objective assessment of surgical quality is essential to improve surgical outcomes.
SUMMARY: There is strong evidence that IMA graft use is associated with significantly improved short-term and long-term survival in CABG. In spite of this, the prevalence of IMA grafting is less than expected. Moreover, there is a large variability in IMA use by hospital. There are also disparities in IMA use by sex and race, which should be addressed in the interest of expanding the benefits of IMA grafting to the maximum possible number of patients. Although the frequency of IMA use in CABG procedures seems to increase each year, further actions are necessary at the individual clinician, institutional, and political levels to improve quality of care.
Authors:
Jan D Schmitto; Taufiek K Rajab; Lawrence H Cohn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  25     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-12     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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