ATS
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 Similar articles in PubMed
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):
Chaim Locker
Rephael Mohr
Oren Lev-Ran
Gideon Uretzky
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Locker, C.
Right arrow Articles by Shapira, I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Locker, C.
Right arrow Articles by Shapira, I.
Related Collections
Right arrow Coronary disease

Ann Thorac Surg 2004;78:471-475
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Comparison of bilateral thoracic artery grafting with percutaneous coronary interventions in diabetic patients

Chaim Locker, MDa, Rephael Mohr, MDa*, Oren Lev-Ran, MDa, Gideon Uretzky, MDa, Aharon Frimerman, MDa, Yael Shaham, MDa, Itzhak Shapira, MDa

a Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Accepted for publication February 6, 2004.

* Address reprint requests to Dr Mohr, Dept of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
e-mail: shapiraiz{at}tasmc.health.gov.il

BACKGROUND: This study compares the outcome of percutaneous coronary interventions (PCI) with bilateral internal thoracic grafting (BITA) in diabetic patients.

METHODS: From May 1996 to December 1999, 802 consecutive diabetic patients underwent myocardial revascularization: 363 by PCI and 439 by BITA. The two groups were similar; however, left main disease (28% versus 3.3%), ejection fraction less than 0.35 (14.5% versus 5.5%), and chronic obstructive lung disease (8.4% versus 3%) were more prevalent in the BITA group, and prior percutaneous transluminal coronary angioplasty, in the PCI group (16.8% versus 10.5%).

RESULTS: The number of coronary vessels treated per patient was higher in the BITA group (3.4 versus 1.2; p < 0.001). Thirty-day mortality was similar: 3.4% in the BITA group and 2.8% in the PCI group. Late follow-up (3 to 6.5 years) showed decreased return of angina (11% versus 64%; p < 0.001), fewer reinterventions (2.7% versus 55%; p < 0.001), and increased cardiovascular event-free survival (80% versus 30%; p < 0.001) in the BITA group. Six-year survival of BITA and PCI patients was 85.5% and 81.2%, respectively (not significant). However, survival of the subgroups of patients with left main or three-vessel coronary artery disease was significantly better with BITA (86% versus 76%; p = 0.003).

CONCLUSIONS: Despite higher risk profile of diabetic patients treated surgically by BITA, their late outcome is better than that of patients treated by PCI. The results of this study support referring diabetics with single-vessel or double-vessel disease to PCI and those with three-vessel and left main coronary artery disease to surgery.






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 © 2004 by The Society of Thoracic Surgeons.