JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Danny Chu
Faisal G. Bakaeen
Joseph S. Coselli
Scott A. LeMaire
Joseph Huh
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chu, D.
Right arrow Articles by Huh, J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Chu, D.
Right arrow Articles by Huh, J.
Related Collections
Right arrow Coronary disease
Right arrowRelated Article

J Thorac Cardiovasc Surg 2009;137:60-64
© 2009 The American Association for Thoracic Surgery

Acquired Cardiovascular Disease

The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting

Danny Chu, MDa,b,*, Faisal G. Bakaeen, MDa,b, Xing Li Wang, MD, PhDa,c, Joseph S. Coselli, MDa,c, Scott A. LeMaire, MDa,c, Joseph Huh, MDa,b

a Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Tex
b Division of Cardiothoracic Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Tex
c Section of Adult Cardiac Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Tex

Received for publication June 10, 2008; revisions received August 14, 2008; accepted for publication September 7, 2008.

* Address for reprints: Danny Chu, MD, Assistant Professor of Surgery, Division of Cardiothoracic Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, 2002 Holcombe Blvd, OCL 112, Houston, TX 77030. (Email: dchumd{at}gmail.com).

Objective: Incomplete myocardial revascularization decreases survival for patients undergoing coronary artery bypass grafting. The effects of constructing multiple grafts to each major diseased artery territory are unknown. We aimed to determine the impact on long-term survival after coronary artery bypass grafting of placing multiple grafts to each myocardial territory.

Methods: We reviewed data from 1129 consecutive patients who underwent coronary artery bypass grafting at our institution between 1997 and 2007 and compared outcomes between patients who received multiple grafts to each major diseased artery territory (n = 549) with those of patients who received single grafts to each territory (n = 580). We assessed long-term survival with Kaplan–Meier curves generated by log-rank tests, adjusting for confounding factors with Cox proportional hazards regression analysis.

Results: Patients who received multiple grafts to each major diseased artery territory had longer cardiopulmonary bypass and aortic crossclamp times than patients who received single grafts per territory. Patient groups had similar early outcomes, including 30-day mortalities (1.3% vs 1.4%, P > .999) and incidences of major adverse cardiac events (2.9% vs 2.2%, P = .57). Cox regression 10-year survival curves were also similar between groups (adjusted hazard ratio 0.94, 95% confidence interval 0.67–1.34, P = .74).

Conclusion: Patients who received multiple grafts to each major diseased artery territory had early outcomes similar to those who received single grafts per territory. Constructing multiple grafts to each major diseased artery territory increases operative time and does not improve long-term survival.

Abbreviations and Acronyms CABG = coronary artery bypass grafting; CAD = coronary artery disease; CICSP = Continuous Improvement in Cardiac Surgery Program; MEDVAMC = Michael E. DeBakey Veterans Affairs Medical Center; PCI = percutaneous coronary intervention; VA = Department of Veterans Affairs


Related Article

Impact of multiple grafts to each myocardial territory on long-term survival
Enoch Akowuah, Sanjay Theodore, and James Tatoulis
J. Thorac. Cardiovasc. Surg. 2009 138: 513. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. Akowuah, S. Theodore, and J. Tatoulis
Impact of multiple grafts to each myocardial territory on long-term survival.
J. Thorac. Cardiovasc. Surg., August 1, 2009; 138(2): 513 - 513.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. Chu and F. G. Bakaeen
Reply to the Editor
J. Thorac. Cardiovasc. Surg., August 1, 2009; 138(2): 513 - 514.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The American Association for Thoracic Surgery.