Propensity-matched analysis of bilateral internal mammary artery vs single internal mammary artery in 7702 cases of isolated coronary artery bypass grafting

Aya Saito, Hiroaki Miyata, Noboru Motomura, Minoru Ono, Shinichi Takamoto

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate early outcomes of bilateral internal mammary artery (BIMA) compared with single IMA (SIMA) in patients who underwent isolated coronary artery bypass grafting (CABG). METHODS: Patients who received isolated CABG with SIMA or BIMA were retrospectively reviewed using the Japan Adult Cardiovascular Surgery Database from 210 institutions for 2008 and 2009. We performed a one-to-one matched analysis on the basis of estimated propensity scores for patients receiving either SIMA or BIMA and obtained two cohorts with 3851 patients in each group balanced for baseline characteristics out of 8136 SIMA and 4093 BIMA patients. We compared procedures actually performed, early outcomes including 30-day operative mortality and details of postoperative complications between the groups using Pearson's chisquare test, with P < 0.05 being statistically significant. RESULTS: Preoperative profiles in both groups included 20% females and 50% diabetes mellitus patients with a mean age of 67 years. Off-pump CABG was similar in both groups, being performed 75% of the time, with the mean number of anastomosis being 3.1 and 3.4 in the SIMA and BIMA groups, respectively (P < 0.0001). Thirty-day operative mortality was 1.2% in both groups, and the overall incidence of postoperative complications also was similar, although deep sternal infection was more frequent with BIMA (1.3 of SIMA and 2.3% of BIMA patients; P = 0.0001), while prolonged ventilation and renal failure were more frequent with SIMA (P < 0.05). CONCLUSIONS: The use of BIMA did not affect either short-term survival as postoperative mortality was low in both groups, or overall morbidity despite higher incidence of deep sternal infection.

Original languageEnglish
Article numberezt157
Pages (from-to)711-717
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume44
Issue number4
DOIs
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Mammary Arteries
Coronary Artery Bypass
Mortality
Off-Pump Coronary Artery Bypass
Propensity Score
Incidence
Infection
Renal Insufficiency
Ventilation
Diabetes Mellitus
Japan
Databases
Morbidity
Survival

Keywords

  • Coronary artery bypass grafting
  • Mammary artery
  • Off-pump

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Propensity-matched analysis of bilateral internal mammary artery vs single internal mammary artery in 7702 cases of isolated coronary artery bypass grafting. / Saito, Aya; Miyata, Hiroaki; Motomura, Noboru; Ono, Minoru; Takamoto, Shinichi.

In: European Journal of Cardio-thoracic Surgery, Vol. 44, No. 4, ezt157, 2013, p. 711-717.

Research output: Contribution to journalArticle

@article{2853d9d930e7440784295b940e6cab23,
title = "Propensity-matched analysis of bilateral internal mammary artery vs single internal mammary artery in 7702 cases of isolated coronary artery bypass grafting",
abstract = "OBJECTIVES: To evaluate early outcomes of bilateral internal mammary artery (BIMA) compared with single IMA (SIMA) in patients who underwent isolated coronary artery bypass grafting (CABG). METHODS: Patients who received isolated CABG with SIMA or BIMA were retrospectively reviewed using the Japan Adult Cardiovascular Surgery Database from 210 institutions for 2008 and 2009. We performed a one-to-one matched analysis on the basis of estimated propensity scores for patients receiving either SIMA or BIMA and obtained two cohorts with 3851 patients in each group balanced for baseline characteristics out of 8136 SIMA and 4093 BIMA patients. We compared procedures actually performed, early outcomes including 30-day operative mortality and details of postoperative complications between the groups using Pearson's chisquare test, with P < 0.05 being statistically significant. RESULTS: Preoperative profiles in both groups included 20{\%} females and 50{\%} diabetes mellitus patients with a mean age of 67 years. Off-pump CABG was similar in both groups, being performed 75{\%} of the time, with the mean number of anastomosis being 3.1 and 3.4 in the SIMA and BIMA groups, respectively (P < 0.0001). Thirty-day operative mortality was 1.2{\%} in both groups, and the overall incidence of postoperative complications also was similar, although deep sternal infection was more frequent with BIMA (1.3 of SIMA and 2.3{\%} of BIMA patients; P = 0.0001), while prolonged ventilation and renal failure were more frequent with SIMA (P < 0.05). CONCLUSIONS: The use of BIMA did not affect either short-term survival as postoperative mortality was low in both groups, or overall morbidity despite higher incidence of deep sternal infection.",
keywords = "Coronary artery bypass grafting, Mammary artery, Off-pump",
author = "Aya Saito and Hiroaki Miyata and Noboru Motomura and Minoru Ono and Shinichi Takamoto",
year = "2013",
doi = "10.1093/ejcts/ezt157",
language = "English",
volume = "44",
pages = "711--717",
journal = "European Journal of Cardio-thoracic Surgery",
issn = "1010-7940",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Propensity-matched analysis of bilateral internal mammary artery vs single internal mammary artery in 7702 cases of isolated coronary artery bypass grafting

AU - Saito, Aya

AU - Miyata, Hiroaki

AU - Motomura, Noboru

AU - Ono, Minoru

AU - Takamoto, Shinichi

PY - 2013

Y1 - 2013

N2 - OBJECTIVES: To evaluate early outcomes of bilateral internal mammary artery (BIMA) compared with single IMA (SIMA) in patients who underwent isolated coronary artery bypass grafting (CABG). METHODS: Patients who received isolated CABG with SIMA or BIMA were retrospectively reviewed using the Japan Adult Cardiovascular Surgery Database from 210 institutions for 2008 and 2009. We performed a one-to-one matched analysis on the basis of estimated propensity scores for patients receiving either SIMA or BIMA and obtained two cohorts with 3851 patients in each group balanced for baseline characteristics out of 8136 SIMA and 4093 BIMA patients. We compared procedures actually performed, early outcomes including 30-day operative mortality and details of postoperative complications between the groups using Pearson's chisquare test, with P < 0.05 being statistically significant. RESULTS: Preoperative profiles in both groups included 20% females and 50% diabetes mellitus patients with a mean age of 67 years. Off-pump CABG was similar in both groups, being performed 75% of the time, with the mean number of anastomosis being 3.1 and 3.4 in the SIMA and BIMA groups, respectively (P < 0.0001). Thirty-day operative mortality was 1.2% in both groups, and the overall incidence of postoperative complications also was similar, although deep sternal infection was more frequent with BIMA (1.3 of SIMA and 2.3% of BIMA patients; P = 0.0001), while prolonged ventilation and renal failure were more frequent with SIMA (P < 0.05). CONCLUSIONS: The use of BIMA did not affect either short-term survival as postoperative mortality was low in both groups, or overall morbidity despite higher incidence of deep sternal infection.

AB - OBJECTIVES: To evaluate early outcomes of bilateral internal mammary artery (BIMA) compared with single IMA (SIMA) in patients who underwent isolated coronary artery bypass grafting (CABG). METHODS: Patients who received isolated CABG with SIMA or BIMA were retrospectively reviewed using the Japan Adult Cardiovascular Surgery Database from 210 institutions for 2008 and 2009. We performed a one-to-one matched analysis on the basis of estimated propensity scores for patients receiving either SIMA or BIMA and obtained two cohorts with 3851 patients in each group balanced for baseline characteristics out of 8136 SIMA and 4093 BIMA patients. We compared procedures actually performed, early outcomes including 30-day operative mortality and details of postoperative complications between the groups using Pearson's chisquare test, with P < 0.05 being statistically significant. RESULTS: Preoperative profiles in both groups included 20% females and 50% diabetes mellitus patients with a mean age of 67 years. Off-pump CABG was similar in both groups, being performed 75% of the time, with the mean number of anastomosis being 3.1 and 3.4 in the SIMA and BIMA groups, respectively (P < 0.0001). Thirty-day operative mortality was 1.2% in both groups, and the overall incidence of postoperative complications also was similar, although deep sternal infection was more frequent with BIMA (1.3 of SIMA and 2.3% of BIMA patients; P = 0.0001), while prolonged ventilation and renal failure were more frequent with SIMA (P < 0.05). CONCLUSIONS: The use of BIMA did not affect either short-term survival as postoperative mortality was low in both groups, or overall morbidity despite higher incidence of deep sternal infection.

KW - Coronary artery bypass grafting

KW - Mammary artery

KW - Off-pump

UR - http://www.scopus.com/inward/record.url?scp=84896948736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896948736&partnerID=8YFLogxK

U2 - 10.1093/ejcts/ezt157

DO - 10.1093/ejcts/ezt157

M3 - Article

VL - 44

SP - 711

EP - 717

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 4

M1 - ezt157

ER -