Mid-term Outcomes of Total Arterial Revascularization Versus Conventional Coronary Surgery in Isolated Three-Vessel Coronary Disease.
10.3346/jkms.2012.27.9.1051
- Author:
Jin Woo CHUNG
1
;
Joon Bum KIM
;
Sung Ho JUNG
;
Suk Jung CHOO
;
Hyun SONG
;
Cheol Hyun CHUNG
;
Jae Won LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Comparative Study
- Keywords:
Coronary Artery Bypass Grafting;
Arteries;
Veins
- MeSH:
Aged;
Cohort Studies;
*Coronary Artery Bypass;
Coronary Disease/complications/mortality/*surgery;
Female;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Myocardial Infarction/etiology;
Myocardial Revascularization;
Prospective Studies;
Risk Factors;
Stroke/etiology;
Treatment Outcome
- From:Journal of Korean Medical Science
2012;27(9):1051-1056
- CountryRepublic of Korea
- Language:English
-
Abstract:
Whether arterial conduits are superior to venous grafts in coronary artery bypassing has been debated. The aim of this study was to investigate clinical outcomes after total arterial revascularization versus conventional coronary bypassing using both arterial and venous conduits in isolated three-vessel coronary disease. Between 2003 and 2005, 503 patients who underwent isolated coronary artery bypass grafting for three-vessel coronary disease were enrolled. A total of 117 patients underwent total arterial revascularization (Artery group) whereas 386 patients were treated with arterial and venous conduits (Vein group). Major adverse outcomes (death, myocardial infarction, stroke and repeat revascularization) were compared. Clinical follow-up was complete in all patients with a mean duration of 6.1 +/- 0.9 yr. After adjustment for differences in baseline risk factors, risks of death (hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.51-1.82, P = 0.90), myocardial infarction (HR 0.20, 95% CI 0.02-2.63, P = 0.22), stroke (HR 1.29, 95% CI 0.35-4.72, P = 0.70), repeat revascularization (HR 0.64, 95% CI 0.26-1.55, P = 0.32) and the composite outcomes (HR 0.83, 95% CI 0.50-1.36, P = 0.45) were similar between two groups. Since the use of veins does not increase the risks of adverse outcomes compared with total arterial revascularization, a selection of the conduit should be more liberal.
