Multivessel Coronary Artery Disease
Conditions
Keywords
Coronary Artery Bypass Grafting, Mammary Artery Grafts, Bilateral Mammary Artery Grafting, Clinical Outcomes
Brief summary
The present study hypothesizes that the systematic use of bilateral internal mammary artery (BIMA) grafting is feasible in the practice of a University Cardiac Surgery Institution for the treatment of multivessel coronary artery disease (primary hypothesis). The secondary study hypothesis is that the BIMA grafting meets the safety endpoint compared with the conventional surgical strategy entailing left mammary artery grafting plus great saphenous vein grafts to revascularize the remaining coronary targets. The tertiary study hypothesis is that the BIMA grafting yields better follow-up results in terms of recurrence of symptoms related to coronary disease, of repeat revascularization and of cardiac mortality compared with patients treated with the conventional surgical strategy entailing left mammary artery grafting plus great saphenous vein grafts to revascularize the remaining coronary targets.
Interventions
PROCEDUREBIMA Grafting
Both the left and the right internal mammary arteries are harvested and used to revascularize the two major coronary targets. Further coronary targets may be revascularized using either great saphenous vein or radial artery grafts, if present.
PROCEDURELeft-only mammary artery grafting
These patients had only the left mammary artery harvested and used to revascularize the major coronary target. Great saphenous vein grafts and/or radial artery grafts were employed to revascularize the remaining targets.
Sponsors
Catholic University, Italy
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patiens undergoing primary or elective-urgent isolated multivessel Coronary Artery Bypass Grafting (CABG) Surgery
Exclusion criteria
* Emergency status * Previous cardiac operation * Any associated cardiac procedure other than CABG Surgery * Left Ventricular Ejection Fraction \<20%
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of systematic BIMA grafting | 2012-2014 (2 years) | Starting in June 2012, all clinical data concerning patients undergoing BIMA grafting are recorded, including the baseline demographics and risk factors, the operative time, all in-hospital complications, duration of Intensive care Unit and Hospital stays, the amount of transfusion of blood products. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical results at follow-up | 2012-2016 (4 years) | The patients enrolled in the study are subjected to longitudinal follow-up to determine the rate of residual myocardial ischemia (periodical stress ECG), of recurrent symptoms of coronary disease, and of any adverse cardiac event (periodical follow-up visits). |
Countries
Italy
Contacts
Primary ContactMassimo Massetti, MD, PhD
Outcome results
None listed