Bilateral internal thoracic arteries: what is the State of the ART?

Abstract:

PURPOSE OF REVIEW:To provide a broad overview of the current state of knowledge of coronary artery bypass grafting with bilateral internal thoracic artery (BITA). RECENT FINDINGS:There exists a large body of literature from mostly observational studies supporting the use of BITA in patients undergoing coronary artery bypass grafting but selection bias is a major issue with nonrandomized data. The precise method of BITA use does not appear to impact graft patency nor clinical outcomes - in other words, BITA in any configuration appears to be protective. The major downside is the increased risk of sternal complications, which can be mitigated with sternal-sparring adjuncts. The 5-year interim results of the landmark Arterial Revascularization Trial comparing BITA versus single internal thoracic artery did not show a clinical benefit for BITA but the end-of-trial results are pending. Despite wide guideline support for BITA use, uptake in the surgical community remains low and this is likely because of technical and institutional barriers. SUMMARY:The published literature thus far supports surgical revascularization with BITA and we eagerly await the 10-year Arterial Revascularization Trial results. The general consensus is that a greater proportion of surgical revascularization should be performed using BITA.

journal_name

Curr Opin Cardiol

authors

Yanagawa B,Verma S,Puskas JD

doi

10.1097/HCO.0000000000000431

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

594-599

issue

5

eissn

0268-4705

issn

1531-7080

pii

00001573-201709000-00016

journal_volume

32

pub_type

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