Outcomes Following Surgical Revascularization With Single Versus Bilateral Internal Thoracic Arterial Grafts in Patients With Left Main Coronary Artery Disease Undergoing Coronary Artery Bypass Grafting: Insights From the EXCEL Trial [1]
The EXCEL is one of several prospective studies that examine the use of single versus bilateral internal thoracic artery (ITA) grafts for myocardial revascularization (in this case, compared with percutaneous coronary intervention) for left main disease. This did not show differences in the surgical population (905 patients) between one and two ITA grafts with regard to mortality and DSWI. There are significant limitations in the patient allocation process that make the value of these outcomes less than helpful.