Clinical Validation of a Coronary Surgery Technique That Minimizes Aortic Manipulation

Bilateral Internal Thoracic Artery Grafting Concomitant With Other Cardiac Operations ― Insights From a European Multicenter Retrospective Study on 1,123 Consecutive Patients ―

“…Both ITAs were dissected as skeletonized conduits, and the ITA harvesting technique did not change in the 3 centers during the study period (Supplementary Methods). 5,[7][8][9][10][11][12][13]17,26,27 All coronary anastomoses on the inferolateral cardiac wall were performed before any other surgical procedure that involved cardiac valves, the left ventricle, or thoracic aorta. Cardiac tumor removal and operations for arrhythmias were included in the study.…”

“…Long-term outcomes were comparable with those of other similar studies in the literature, 28-38 but, as expected, poorer than those for isolated BITA grafting. [5][6][7][8][9][10][11][12][13]15,17,27,39,40 In this series of patients with an average age of more than 70 years, approximately 50% of subjects were alive or free from MACCE at 10 years after surgery; approximately 85% of patients were free from cardiac or cerebrovascular death or from hospital readmission for CHF; approximately 97% of patients were free from PCI or cardiac reoperation; finally, approximately 95% of patients were free from cerebrovascular accident after hospital discharge. Although female sex, extracardiac arteriopathy, chronic dialysis, and poor systolic function before surgery were risk factors for both cardiac or cerebrovascular death and MACCE, active infective endocarditis and prolonged myocardial ischemia during surgery were the sole predictors of repeat operation or PCI.…”