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Ann Thorac Surg 1995;59:1456-1463
© 1995 The Society of Thoracic Surgeons

Does It Make Sense to Use Two Internal Thoracic Arteries?

Eric Berreklouw, MD, Jacques P. A. M. Schönberger, MD, PhD, Hüsamettin Ercan, MD, Evert L. Koldewijn, MD, Marcel de Bock, MD, Victor J. Verwaal, MD, Frits van der Linden, MD, Ingeborg van der Tweel, PhD, Johannus H. Bavinck, MD, Johan J. Bredée, MD, PhD

Department of Cardio-thoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands

Accepted for publication February 17, 1995.

Retrospectively, the first 143 patients who were operated on with bilateral internal thoracic arteries (BITA group) were matched with 143 patients operated on with only one left internal thoracic artery anastomosed on the left anterior descending artery and additional vein grafts (LITA group) and followed up for a maximum of 8 years. At 5 years follow-up there were no significant differences in event-free survival between the groups. After 8 years, the overall survival was 96% and 92% (not significant [NS]), cardiac survival 99% and 97% (NS), angina-free cardiac survival 51% and 35% (NS), infarction-free cardiac survival 95% and 78% (NS), reintervention-free cardiac survival 87% and 88% (NS), and all cardiac event-free survival 49% and 31% (NS) for the BITA and LITA groups, respectively. The incidence of late pulmonary, wound, and other complications was comparable. Cox proportional hazards analysis showed that a higher left ventricular end-diastolic pressure and female sex were predictors of recurrent angina and late cardiac events. During this intermediate-term follow-up, the use of one or two internal thoracic arteries was of no value in predicting angina-free or cardiac event-free survival.




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