SHORT- AND LONG-TERM OUTCOMES OF A SECOND ARTERIAL CONDUIT FOLLOWING
CORONARY BYPASS GRAFTING
Abstract
Background: The aim of this study was to assess the effect on short-term
outcomes and long-term survival in patients following coronary artery
bypass grafting in whom second arterial conduit(right internal thoracic
artery-RITA or radial artery-RA) or saphenous vein was grafted and
between RITA and RA as second best arterial conduit. Methods: Between
January-2006 and June-2018, 7857-patients met the inclusion criteria and
were divided into two groups: single internal thoracic artery: SITA+Vein
group(n=7140) and 2nd-arterial conduit group(n=717), of these
537-patients received RITA and 180-patients received RA. Short‐term
outcomes included: 30-day mortality and Major Adverse Cardiac and
Cerebral Events(MACCE), reoperation for bleeding and deep sternal wound
infection(DSWI). The long‐term outcome was all‐cause mortality.
propensity score(PS) matching was used to match patients between the
groups. Results: Before as well as after PS-matching, no significant
differences were observed between 2nd-arterial conduit vs SITA+Vein
groups and between RITA vs RA groups in terms of 30-day mortality,
30-day MACCE, reoperation for bleeding and incidence of DSWI. The use of
2nd-arterial conduit was associated with a significant reduction in
long-term mortality before(HR:0.52;95%CI;0.43-0.64;p<0.001)
as well as after PS-matching(HR:0.77;95%CI;0.60-0.99;p=0.04). RA and
RITA as second arterial conduit had comparable long-term mortality
before(HR:1.22;95%CI;0.82-1.82;p=0.3) as well as after
PS-matching(HR:0.96;95%CI;0.58-1.58;p=0.87). Conclusions: The use of
2nd-arterial conduit vs vein is associated with improved long-term
survival. As for the 2nd-best arterial conduit, RA and RITA had
comparable long-term mortality.