AI Article Synopsis
- A study aimed to evaluate the outcomes of coronary surgery using total arterial revascularization (TAR) compared to conventional revascularization (CR) in patients with multivessel or isolated left main disease.
- After randomizing 331 patients, the primary outcome measured was the patency index of grafts after one year, which showed similar results for both TAR (87%) and CR (88%) groups.
- Both groups experienced similar rates of cardiac events and deaths within the year, suggesting that TAR is at least as safe and effective as CR, though long-term effects remain to be seen.
Article Abstract
Aims: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR).
Methods And Results: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional revascularization (CR) using left ITA and vein grafts. The primary angiographic outcome was the patency index: number of patent grafts (<50% stenosed) divided by number of constructed grafts. One-year angiography was complete for 83% of patients. Mean patency index (+/-SD) was 87 +/- 22% in the TAR group and 88 +/- 18% in the conventional group (P = 0.52). In 72% of TAR patients and 67% of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23%) TAR patients and 43 (25%) conventional group patients suffered cardiac events (HR 1.09, 95% CI 0.70-1.69, P = 0.70). One patient (0.6%) in the TAR group and two (1.2%) in the conventional group died (P = 1.00).
Conclusion: Within 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained or superior results of TAR can justify a more general use.
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| http://dx.doi.org/10.1093/eurheartj/ehp048 | DOI Listing |
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