1. On-Pump versus Off-Pump Complete Arterial Revascularization Using Bilateral Internal Mammary Arteries and the T-Graft Technique: Clinical and Angiographic Results for 3,445 Patients in 13 Years of Follow-Up
- Author
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Nizar Awwad, Eva Cramer, Claas Lehmann, Stephan Winkel, Stefan Heller, Peter Kremer, Joachim Schofer, Jan Stripling, Lorenz Hansen, Wagma Amin, and Friedrich-Christian Riess
- Subjects
Male ,Reoperation ,Coronary angiography ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Coronary artery disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Risk Factors ,Germany ,Internal medicine ,Humans ,Medicine ,Pharmacology (medical) ,Myocardial infarction ,Coronary Artery Bypass ,Mammary Arteries ,Stroke ,Aged ,Retrospective Studies ,business.industry ,Percutaneous coronary intervention ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Logistic Models ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Mammary artery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Artery - Abstract
Background: This is an investigation of complete arterial coronary artery bypass grafting (CACABG) using bilateral internal mammary arteries (IMA) and the T-graft technique either on- or off-pump as a routine approach to treat coronary artery disease. Methods: Between January 2000 and December 2012, 3,445 patients underwent on-pump (n = 2,216) or off-pump (n = 1,229) CACABG. A 30-day follow-up was performed prospectively, a long-term follow-up by a questionnaire, and coronary angiography in selected patients. Results: End points at 30 days were death, myocardial infarction, stroke, repeat revascularization, renal replacement, reoperation, sternal wound infection and atrial fibrillation. FitzGibbon A patency rates were 89.8 vs. 91.4% (p = 0.464) with consecutive percutaneous coronary intervention in the grafted area of 1.8 vs. 1.1% (p = 0.693) on- vs. off-pump, and no reoperation in the grafted area in both groups. Conclusion: CACABG by use of skeletonized bilateral IMA with the T-graft technique performed either on- or off-pump is a safe and effective approach.
- Published
- 2016
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