%0 Journal Article %T A meta-analysis comparing bilateral internal mammary artery with left internal mammary artery for coronary artery bypass grafting %A Weiss, Aaron J. %A Zhao, Shan %A Tian, David H. %A Taggart, David P. %A Yan, Tristan D. %J Annals of Cardiothoracic Surgery %D 2013 %B 2013 %9 %! A meta-analysis comparing bilateral internal mammary artery with left internal mammary artery for coronary artery bypass grafting %K %X 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. %U https://www.annalscts.com/article/view/2399 %V 2 %N 4 %P 390-400 %@ 2304-1021