TY  - JOUR
AU  - Weiss, Aaron J.
AU  - Zhao, Shan
AU  - Tian, David H.
AU  - Taggart, David P.
AU  - Yan, Tristan D.
PY  - 2013
TI  - A meta-analysis comparing bilateral internal mammary artery with left internal mammary artery for coronary artery bypass grafting
JF  - Annals of Cardiothoracic Surgery; Vol 2, No 4 (July 30, 2013): Total arterial revascularization
Y2  - 2013
KW  - 
N2  -  Background:  Increasing evidence continues to demonstrate a survival advantage for bilateral internal mammary artery (BIMA) over left internal mammary artery (LIMA) for coronary artery bypass grafting (CABG). We performed an updated meta-analysis of published studies comparing BIMA versus LIMA in CABG operations and assessed differences in long-term survival.    Methods:  Electronic searches for studies comparing BIMA versus LIMA were performed using three databases from 1972 to December 2012. Studies with at least four years of follow-up and at least 100 patients in each group were included for review. We used a random-effect model and pooled hazard ratios from across all included studies.    Results:  No randomized controlled trials and 27 observational studies totaling 79,063 patients (19,277 BIMA, 59,786 LIMA) were included for final analysis. The BIMA group demonstrated significantly better long-term survival than the LIMA group [hazard ratio, 0.78; confidence interval, 0.72-0.84; P<0.00001].    Conclusions:  In an updated meta-analysis, we demonstrate an increase in long-term survival in patients receiving BIMA as a primary grafting strategy over those receiving a LIMA. Although no randomized controlled trials were included in this meta-analysis, the survival benefit seen with a BIMA cannot be overlooked when determining which operation to perform in CABG patients. Until the long-term results of the ART trial are published, we offer best available evidence in favor of BIMA over LIMA for CABG surgery.
UR  - https://www.annalscts.com/article/view/2399