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

Tuesday, October 29, 2019

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Source Name: Journal of the American College of Cardiology


Joanna Chikwe, Erick Sun, Edward L. Hannan, Shinobu Itagaki, Timothy Lee, David H. Adams, and Natalia N. Egorova

This article reviews real-life outcomes of 42,714 patients undergoing coronary bypass grafting from 2005 to 2012. After adjusting for the differences in the populations, the patients who received multiple arterial grafts had lower long-term mortality, myocardial infarction, and re-intervention rates than patients who received a single arterial graft. More telling, however, is the fact that only 15% of patients in the study group received more than one arterial graft.


Amen to multiple arterial grafts we should follow the evidence.
Resurgence of literature in recent years favoring multiple arterial grafts should really facilitate paradigm shift moving away from “All-American triple bypass”. I personally feel obligated to add radial artery to almost every patient younger than 80 yo. I routinely use BIMA Y-grafts to the left territory in young muscular patients with large IMAs. I am cautious about using arterial grafts to RCA due to size mismatch and literature that shows that vein demonstrated better results(?)

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