183THE USE OF BILATERAL INTERNAL THORACIC ARTERIES INCREASES LONG-TERM SURVIVAL IN ELDERLY PATIENTS: A PROPENSITY-MATCHED ANALYSIS

• Published in: Interactive cardiovascular and thoracic surgery Vol. 17; no. suppl_2; pp. S113 - S114
• Main Authors: Pettinari, M., Meuris, B., Sergeant, P.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2013
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt372.183

Objectives: Bilateral internal thoracic arteries (BITA) are extensively underused in coronary artery bypass graft (CABG) surgery and are mostly reserved for patients under the age of 70 years. The purpose of the present study is to compare outcome in propensity score-matched patients aged 70 years or greater using BITA, with that of patients in whom a single internal thoracic artery (SITA) was used. Methods: Among 18 761 patients operated on in our unit until December 2006, we selected 3496 patients aged 70 years or greater; of these 1328 received BITA (BITA group) and 2168 received a SITA (SITA group). Propensity score matching was used to reduce preoperative patient variability. The three-month and 10-year survival, stroke, myocardial infarction and sternal wound complication rates were compared between the two groups. Results: After the correction, 1173 patients per group were selected. The three-month survival was similar (89.3%, CI = 87.4-91.3%, in the SITA group vs 91.2%, CI = 89.3-93.1%, in the BITA group, P = 0.26), but the 10-year survival was significantly higher in the BITA group (40.8%, CI = 34.9-47.7%, vs 55.1%, CI = 49.9-60.8%, P < 0.01). The incidence of myocardial infarction (0.9% vs 0.9%, P = 1) and stroke (0.5% vs 0.6%, P = 1) did not differ, but sternal wound complications were more common in the BITA group (0.6% vs 1.4%, P < 0.01). Conclusions: The use of bilateral thoracic arteries improves the long-term survival after CABG, but increases the risk of postoperative sternal wound complications. A more extensive use in the elderly population should be advocated, but only in selected patients with low risk of sternal complications.