Background: We compared the long-term clinical outcomes and 5-year angiographic patency after off-pump coronary artery bypass (OPCAB) using bilateral internal thoracic arteries (ITAs) as in situ grafts with those after OPCAB using bilateral ITAs as Y-composite grafts.
Methods: Of 398 patients who underwent OPCAB, bilateral ITAs were used as in situ grafts in 164 patients and as Y- composite grafts in 234 patients. Propensity-matched analysis was used to match patients using bilateral ITA in situ grafts (group I, N = 110) with patients using bilateral ITA Y-composite grafts (group Y, n = 110). Clinical outcomes during follow-up of 95 ± 31 months, and early, 1-year and 5-year graft patency rates were compared.
Results: No differences were observed in early mortality (2/110 vs 1/110; p > 0.999) and postoperative complications between groups I and Y. Early, 1-year and 5-year postoperative angiographies were performed in 217, 202 and 167 patients, respectively. There were no significant differences in patency rates of overall grafts and bilateral ITAs between the groups. Overall survival rates (p = 0.413) and freedom from cardiac death (p = 0.720) were not different between the two groups, and 8-year freedom from cardiac death rates were 95.1% in group I and 95.2% in group Y, respectively. Reintervention-free survival and major adverse cardiac and cerebrovascular event-free survival were also similar between the two groups (p = 0.361 and p = 0.128, respectively).
Conclusions: No differences were observed between bilateral ITA in situ and Y-composite grafts in long-term clinical and 5-year angiographic results.
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