Current Trends in Bilateral Internal Mammary Artery Use for Coronary Revascularization: Extending Benefit to High-Risk Patients

Wednesday, February 28, 2018

Submitted by

Arie Blitz

Source

Source Name: Journal of Thoracic and Cardiovascular Surgery

Source URL: http://www.jtcvsonline.org/article/S0022-5223(18)30400-8/fulltext

Author(s)

Nishan Saran, Chaim Locker, Sameh M. Said, Richard C. Daly, Simon Maltais, John M. Stulak, Kevin L. Greason, Alberto Pochetino, Hartzell V. Schaff, Joseph A. Dearani, Lyle D. Joyce, Brian D. Lahr, David L. Joyce

The Mayo Clinic team retrospectively reviewed their experience with isolated CABG for multivessel coronary artery disease over a 15-year period to assess usage of bilateral internal mammary arteries (BIMA) and selected outcomes. The population included a total of 6468 isolated CABG procedures.

Some of the salient findings from their study are:

The use of BIMA doubled over the most recent 4-year period (13% to 27%).
Propensity-matched patients exhibited a survival advantage for BIMA patients, with a hazard ratio of 0.81.
Sternal infection was not significantly higher in the BIMA group.

The authors conclude that BIMA use should be encouraged and expanded.

Comments

Submitted by Patrick Myers on Sat, 2018-03-03 01:48

Thanks for a very clear and concise summary of this nice study. Impressive to see BIMA use go from 13% to 27%, while STS database data still tells us overall BIMA use remains below 10%.