HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): François Dagenais Daniel Doyle Patrick Mathieu Richard Baillot Eric Charbonneau Jean Perron Pierre Voisine Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mohammadi, S. Articles by Voisine, P. Search for Related Content PubMed PubMed Citation Articles by Mohammadi, S. Articles by Voisine, P. Related Collections Coronary disease

Age cut-off for the loss of benefit from bilateral internal thoracic artery grafting

Department of Cardiac surgery, Laval Hospital, 2725 chemin Ste-Foy, Québec city, QC, Canada, G1V 4G5

Received 8 October 2007; received in revised form 5 March 2008; accepted 19 March 2008.

^_* Corresponding author. Tel.: +1 418 656 4717; fax: +1 418 656 4707. (Email: pierre.voisine{at}chg.ulaval.ca).

Objectives: To identify the age-related benefit of single and bilateral internal thoracic artery (ITA) grafting on long-term cardiac-related survival in patients who survived from primary isolated coronary artery bypass grafting (CABG). Methods: A unicenter study was conducted on 12,231 consecutive survivors from primary isolated CABG who received single (n = 9566 patients) or bilateral (n = 1388 patients) ITA grafts, or vein grafts only (n = 1277 patients) between 1992 and 2005. Data was collected prospectively. The Cox regression model estimates the hazard ratio of each independent variable on cardiac-specific survival over the entire length of follow-up. Age was a significant covariate into the statistical model. The mean follow-up was 5.7 ± 3.7 years and 100% complete as of December 2005. The date and cause of death were obtained from the regional statistical institute. Results: After adjustments for different risk factors, the cardiac-related survival benefit in patients undergoing CABG with two ITAs was superior to that of single ITA grafting up to 60 years of age, displaying a constant decrease over time. The use of a single ITA was beneficial on cardiac-related survival in all age groups, including octogenarians, compared to patients receiving only vein grafts. Conclusions: The use of at least one ITA is associated with increased long-term cardiac-specific survival in all age groups compared to venous-only CABG, even in octogenarians. The additional survival benefit of using a second ITA decreases gradually with age, and is lost after 60 years of age.

Key Words: Coronary artery bypass • Bilateral internal thoracic arteries • Long-term survival

This article has been cited by other articles:

				E. Apostolakis and K. Akinosoglou Is the use of at least one internal thoracic artery (ITA) directly associated with increased long-term cardiac-specific survival? Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 747 - 748. [Full Text] [PDF]

				T. Bottio, V. Tarzia, G. Rizzoli, and G. Gerosa Total arterial revascularization, conventional coronary artery bypass surgery, and age cut-off for the loss of benefit from bilateral internal thoracic artery grafting Eur. J. Cardiothorac. Surg., January 1, 2009; 35(1): 191 - 191. [Full Text] [PDF]