Is There an Advantage to Multiarterial Grafts in Multivessel Coronary Artery Disease?

After 10 years, bilateral and single internal-thoracic-artery graft groups showed no difference in mortality.

Grafting the left internal thoracic artery (ITA) contributes to the benefits of coronary-artery bypass grafting (CABG) because its long-term patency is superior to vein grafts. In the randomized, multicenter Arterial Revascularization Trial, investigators compared bilateral and single ITA grafting in 3102 patients (ISRCTN46552265). An off-pump technique was used in 40% of patients, and ITA grafting to the right coronary artery was not allowed. The 5-year interim analysis showed no mortality difference between groups. Now, the investigators report 10 years' follow-up in 98% of patients.

The two groups did not differ in the primary endpoint of mortality at 10 years (bilateral-graft group, 20%; single-graft group, 21%) and on the secondary endp…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)