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Titolo:
Two internal thoracic artery grafts are better than one
Autore:
Lytle, BW; Blackstone, EH; Loop, FD; Houghtaling, PL; Arnold, JH; Akhrass, R; McCarthy, PM; Cosgrove, DM;
Indirizzi:
Cleveland Clin Fdn, Dept Thorac & Cardiovasc Surg, Cleveland, OH 44195 USACleveland Clin Fdn Cleveland OH USA 44195 c Surg, Cleveland, OH 44195 USA
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 5, volume: 117, anno: 1999,
pagine: 855 - 869
SICI:
0022-5223(199905)117:5<855:TITAGA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAMMARY-ARTERY; SAPHENOUS-VEIN; PROGNOSTIC MODELS; PROPENSITY SCORE; CORONARY; SINGLE; SURVIVAL; BYPASS; CHOICE; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Lytle, BW Clevelandveland,dn, Dept Thorac & Cardiovasc Surg, F25,9500 Euclid Ave, Cle Cleveland Clin Fdn F25,9500 Euclid Ave Cleveland OH USA 44195 le
Citazione:
B.W. Lytle et al., "Two internal thoracic artery grafts are better than one", J THOR SURG, 117(5), 1999, pp. 855-869

Abstract

Objective: Does the use of bilateral internal thoracic artery (ITA) graftsprovide incremental benefit relative to the use of a single ITA graft? Methods: We conducted a retrospective, nonrandomized, long-term (mean follow-up interval of 10 postoperative years) study of patients undergoing electiveprimary isolated coronary bypass surgery who received either single (8123 patients) or bilateral ITA grafts (2001 patients), with or without additional vein grafts. Multiple statistical methods including propensity score matching, and multivariable parsimonious and nonparsimonious risk factor analyses were used to address the issues of patient selection and heterogeneity. Results: In-hospital mortality was 0.7% for both the bilateral and single ITA groups. Survival for the bilateral ITA group was 94%, 84%, and 67%, andfor the single ITA group 92%, 79%, and 64% at 5, 10, and 15 postoperative years, respectively (P <.001). Death, reoperation, and percutaneous transluminal coronary angioplasty were more frequent for patients undergoing single rather than bilateral ITA grafting, and this observation remained true despite multiple adjustments for patient selection, sampling, and length of follow-up. The differences between the bilateral and single ITA groups were greatest in regard to reoperation. The extent of benefit of bilateral ITA grafting varied according to patient-related variables, but no patient subsets were identified for whom single ITA grafting could be predicted to provide an advantage, Conclusions: Patients who received 2 ITA grafts had decreased risks of death, reoperation, and angioplasty.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 20:06:35