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SHORT- AND LONG-TERM OUTCOMES OF A SECOND ARTERIAL CONDUIT FOLLOWING CORONARY BYPASS GRAFTING
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  • Sleiman Sebastian Aboul-Hassan,
  • Jakub Marczak,
  • Tomasz Stankowski,
  • Lukasz Moskal,
  • Maciej Peksa,
  • Marcin Nawotka,
  • Ryszard Stanislawski,
  • Miroslaw Brykczynski,
  • Romuald Cichon
Sleiman Sebastian Aboul-Hassan
Heart Diseases Center MEDINET
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Jakub Marczak
Heart Diseases Center MEDINET
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Tomasz Stankowski
Sana Heart Center Cottbus
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Lukasz Moskal
Medinet Heart Center
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Maciej Peksa
MEDINET Heart Center Ltd
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Marcin Nawotka
MEDINET Heart Center Ltd.
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Ryszard Stanislawski
MEDINET Heart Center Ltd.
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Miroslaw Brykczynski
Lower Silesian Center for Heart Disease MEDINET
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Romuald Cichon
Medical University of Warsaw
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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.