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Similar Outcomes in Diabetes Patients After Coronary Artery Bypass Grafting With Single Internal Thoracic Artery Plus Radial Artery Grafting and Bilateral Internal Thoracic Artery Grafting

Wednesday, August 23, 2017

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Source Name: Annals of Thoracic Surgery


Sajjad Raza, MD, Eugene H. Blackstone, MD, Penny L. Houghtaling, MS, Marijan Koprivanac, MD, Kirthi Ravichandren, MD, Hoda Javadikasgari, MD, Faisal G. Bakaeen, MD, Lars G. Svensson, MD, PhD, Joseph F. Sabik III, MD

This CCF retrospective study compared outcomes for diabetic patients undergoing CABG who received either (1) bilateral internal thoracic artery (BITA) grafts or (2) single internal thoracic artery  (SITA) plus radial artery (RA) grafts during CABG.  A total of 1,325 patients over a 17-year period were included in the analysis, with a median follow-up of 7.4 years.  Results:  For propensity-matched patients, in-hospital outcomes and long-term survival were similar in the two groups.

Question:  For diabetic patients, should the choice of BITA vs. SITA + RA be considered equivalent?  Why or why not?


It is prausible consensus that ITA-LAD is essencial resauce for ischemic heart as a`life line`. On the other hand, RA and other conduits showed not prominent outcome even if in diabetic patients and various graft design. We have to consider now the arterial graft with sapenous vein graft under less invasive surgery such as OPCAB and/or MICS. Especially in discussion whether skleletonized or not, the charactalistic of graft in long term has to be proben.

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