Skip to Main content Skip to Navigation
Journal articles

Does the Addition of a Gastroepiploic Artery to Bilateral Internal Thoracic Artery Improve Survival?

Abstract : It is unclear whether the additional conduit to supplement bilateral internal thoracic arteries (BITA) influences the patient outcome in coronary surgery. This retrospective study compared long-term survival of patients undergoing left-sided BITA grafting in which the third conduit to the right coronary system (RCA) was either vein graft (SVG) or gastroepiploic artery (GEA). From 1989 to 2014, 1432 consecutive patients underwent left-sided revascularization with BITA associated with SVG (n = 599) or GEA (n = 833) to RCA. Propensity score was calculated by logistic regression model and patients were matched 1 to 1 leading to 2 groups of 320 matched patients. The primary end point was the overall mortality from any cause. GEA was used in significantly lower risk patients. The 30-day mortality was 1.6% without influence of the graft configuration. Postoperative follow-up was 13.6 ± 6.6 years and was 94% complete. The significant difference in patients' survival observed at 20 years in favor of GEA in unmatched groups (48 ± 4% vs 33 ± 6%, P \textless 0.001) was not confirmed in matched groups (41 ± 7% vs 36 ± 7%, P = 0.112). In multivariable Cox model analysis, the conduit used to RCA did not influence the long-term survival in matched groups, like no other graft configuration or operative parameter. Only complete revascularization remained predictor of survival (P = 0.016), with age (P \textless 0.0001), diabetes status (P = 0.007), and left ventricle ejection fraction (P \textless 0.0001). Long-term survival in patients undergoing BITA grafting is not affected by using GEA as third arterial conduit in alternative to SVG. Further studies are necessary to assess its impact on long-term cardiac events.
Document type :
Journal articles
Complete list of metadata

https://www.hal.inserm.fr/inserm-03328422
Contributor : Laboratoire Carmen <>
Submitted on : Monday, August 30, 2021 - 9:21:32 AM
Last modification on : Wednesday, September 1, 2021 - 3:09:31 AM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document

Identifiers

Collections

Citation

O. J. L. Jegaden, F. Farhat, M. P. O. Jegaden, A. O. Hassan, A. Eker, et al.. Does the Addition of a Gastroepiploic Artery to Bilateral Internal Thoracic Artery Improve Survival?. Seminars in Thoracic and Cardiovascular Surgery, WB Saunders, 2021, pp.S1043-0679(21)00018-6. ⟨10.1053/j.semtcvs.2021.01.009⟩. ⟨inserm-03328422⟩

Share

Metrics

Record views

16