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Related Experiment Videos

Bilateral internal thoracic artery operations in the elderly.

J W Jones1, S E Schmidt, C C Miller

  • 1Department of Surgery, Baylor College of Medicine and Veterans Affairs Medical Center, Houston, Texas, USA.

The Journal of Cardiovascular Surgery
|July 20, 2000
PubMed
Summary

Bilateral internal thoracic artery (BITA) bypass grafting is safe for elderly patients undergoing coronary artery bypass surgery. Optimal long-term survival is achieved when both ITAs are grafted to left coronary artery branches.

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Area of Science:

  • Cardiovascular Surgery
  • Geriatric Medicine
  • Thoracic Surgery

Background:

  • Elderly patients face higher risks in complex surgeries.
  • Bilateral internal thoracic arteries (BITA) use is often linked to increased surgical risk.
  • Arterial grafts are resilient to arteriosclerosis, offering long-term benefits.

Purpose of the Study:

  • To evaluate the operative risk of BITA versus single internal thoracic artery (SITA) or saphenous vein grafts (SVG) in elderly patients.
  • To determine if BITA grafting increases operative morbidity or mortality in older individuals.
  • To assess the impact of graft strategy on long-term survival in elderly coronary artery bypass patients.

Main Methods:

  • Retrospective analysis of 673 patients aged over 65 undergoing coronary artery bypass grafting.

Related Experiment Videos

  • Comparison of outcomes among three groups: all vein grafts, SITA with vein grafts, and BITA with vein grafts.
  • Subgroup analysis of BITA patients based on graft placement to left or right coronary arteries.

    • Main Results:

    • Multivariate analysis indicated that bilateral internal thoracic artery (BITA) grafts to left-sided arteries significantly improved long-term survival in elderly patients (p=0.031).
    • The BITA procedure did not demonstrate increased operative morbidity or mortality compared to SITA or SVG in this cohort.
    • Grafting both internal thoracic arteries to left coronary artery branches was associated with superior long-term survival outcomes.

    Conclusions:

    • Bilateral internal thoracic artery (BITA) grafting is a safe and effective option for elderly patients undergoing coronary artery bypass surgery.
    • To maximize long-term survival benefits, both internal thoracic arteries should be utilized for grafting to branches of the left coronary artery.
    • The study supports the use of arterial grafts in elderly patients to enhance long-term quality of life.