ART: Single vs. Bilateral Grafts in CAD Patients Undergoing CABG

There was no significant difference in outcomes between single and bilateral internal-thoracic-artery grafts in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG), according to the results of the ART Trial presented Nov. 14 during AHA 2016 and simultaneously published in the New England Journal of Medicine.

David P. Taggart, MD, et al., randomized 3,102 patients scheduled for CABG to single grafts (1,554) or bilateral grafts (1,448) in 28 cardiac surgical centers in seven countries. The primary outcome was death from any cause. Secondary outcomes included the composite of death, myocardial infarction (MI), stroke and additional safety outcomes.

The results of the study show that at five-years follow-up bilateral surgery provided similar clinical outcomes to single artery grafting. The death rate in the single artery grafting group was 8.4 percent compared to 8.7 percent in bilateral group. The composite of death, MI and stroke was 12.7 percent for single artery grafting vs. 12.2 percent for bilateral grafts.

According to the authors, follow-up to 10 years is ongoing to determine if bilateral grafts provide longer term benefits as single vein graft failure becomes more common after five years.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention

Keywords: AHA16, American Heart Association, AHA Annual Scientific Sessions, Cardiovascular System, Coronary Artery Bypass, Follow-Up Studies, Mammary Arteries, Transplants

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