Outcomes of Second Arterial Conduits in Patients Undergoing Multivessel Coronary Artery Bypass Graft Surgery

Benefits of multiarterial versus single-arterial coronary bypass grafting (CABG) are debated. This study sought to compare long-term survival, morbidity, and graft patency after multiarterial versus single-arterial CABG. Mandatory clinical registries linked with discharge databases were used to iden...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2019-11, Vol.74 (18), p.2238-2248
Main Authors: Chikwe, Joanna, Sun, Erick, Hannan, Edward L., Itagaki, Shinobu, Lee, Timothy, Adams, David H., Egorova, Natalia N.
Format: Article
Language:English
Subjects:
Aged
arterial graft
Cardiology
Cerebral infarction
Clinical medicine
Conduits
Confidence intervals
Coronary artery
Coronary Artery Bypass
Coronary Artery Disease - mortality
Coronary Artery Disease - pathology
Coronary Artery Disease - surgery
coronary revascularization
Coronary vessels
Data collection
Emergency procedures
Female
Grafting
Grafts
Health hazards
Heart attacks
Heart surgery
Humans
Identification methods
Intubation
Male
Middle Aged
Morbidity
Mortality
Myocardial infarction
off-pump coronary bypass surgery
on-pump coronary bypass surgery
Patients
Propensity Score
Proportional Hazards Models
Retrospective Studies
Stroke
Surgeons
Survival
Survival Rate
Treatment Outcome
Variables
Vascular Patency
Vital statistics
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Summary:Benefits of multiarterial versus single-arterial coronary bypass grafting (CABG) are debated. This study sought to compare long-term survival, morbidity, and graft patency after multiarterial versus single-arterial CABG. Mandatory clinical registries linked with discharge databases were used to identify baseline and operative characteristics and outcomes of 42,714 patients undergoing CABG from 2005 through 2012. Patients with single-vessel disease, without arterial conduits, or undergoing emergency, reoperative, or concomitant procedures were excluded. Survival, stroke, myocardial infarction, and repeat revascularization rates were compared using Cox modeling, and patients were matched by propensity score. Median follow-up was 7.8 years (interquartile range: 5 to 10 years); last follow-up was December 31, 2016. Of the 26,124 patients, 3,647 (14.0%) underwent multiarterial CABG. Single-arterial CABG patients were older (mean 68 vs. 61 years; p 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2019.08.1043