One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial
Sune Damgaard1, Jørn Wetterslev, Jens T Lund
1Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. sunedamgaard@dadlnet.dk
European Heart Journal
|March 10, 2009
Summary
Total arterial revascularization (TAR) in coronary surgery is as safe and effective as conventional revascularization (CR) within one year. Further studies will determine if TAR offers superior long-term benefits for broader clinical use.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Coronary artery disease necessitates surgical revascularization.
- Total arterial revascularization (TAR) utilizes both internal thoracic and radial arteries.
- Conventional revascularization (CR) typically employs the internal thoracic artery and vein grafts.
Purpose of the Study:
- To compare clinical and angiographic outcomes of TAR versus CR in patients with multivessel or isolated left main coronary artery disease.
Main Methods:
- A randomized trial involving 331 patients comparing TAR with CR.
- Primary outcome: patency index (patent grafts/total grafts) at one-year angiography.
- Secondary outcomes: graft patency rates and major adverse cardiac events.
Main Results:
- One-year angiography showed similar mean patency indices: 87% (TAR) vs. 88% (CR).
- Graft patency was high in both groups: 72% (TAR) vs. 67% (CR) with all grafts patent.
- One-year cardiac event rates were comparable: 23% (TAR) vs. 25% (CR).
Conclusions:
- Total arterial revascularization (TAR) demonstrates comparable safety and efficacy to conventional revascularization (CR) within one year post-surgery.
- Long-term follow-up is needed to ascertain sustained benefits or superiority of TAR.
