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Related Experiment Video

Updated: May 14, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Twenty-five-year outcomes after multiple internal thoracic artery bypass.

Cyrus J Parsa1, Linda K Shaw2, J Scott Rankin3

  • 1Duke University Medical Center, Durham, NC.

The Journal of Thoracic and Cardiovascular Surgery
|February 14, 2013
PubMed
Summary

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Multiple internal thoracic artery grafts significantly improve coronary artery bypass grafting outcomes, offering greater benefits than single internal thoracic artery grafts. Increased use of multiple internal thoracic artery grafts is recommended to reduce long-term cardiac event risks.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Cardiac Surgery Outcomes

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for multivessel coronary artery disease.
  • The use of multiple internal thoracic artery (ITA) grafts in CABG remains a subject of clinical debate.
  • Assessing single-institution outcomes of multiple ITA grafting is crucial for guiding clinical decisions.

Purpose of the Study:

  • To evaluate the clinical outcomes associated with single versus multiple internal thoracic artery grafts in patients undergoing multivessel coronary artery bypass grafting.
  • To provide evidence-based guidance for the application of multiple ITA grafting in clinical practice.

Main Methods:

  • A prospective database of 19,482 patients undergoing multivessel CABG between 1984 and 2009 was analyzed.

Related Experiment Videos

Last Updated: May 14, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

  • Patients were categorized into three groups: no ITA graft, single ITA graft, and multiple ITA grafts.
  • Outcomes including myocardial infarction, percutaneous coronary intervention, reoperative CABG, and all-cause death were assessed using multivariable Cox modeling and AUC analysis.

    • Main Results:

    • Patients receiving multiple ITA grafts were younger and had lower rates of congestive heart failure, diabetes, and female gender compared to other groups.
    • No significant differences were observed in the number of diseased vessels or grafts per patient across groups.
    • Risk-adjusted analysis showed that multiple ITA grafting reduced the composite outcome by 30% (HR 0.70) compared to no ITA graft, while single ITA grafting reduced it by 21% (HR 0.79).

    Conclusions:

    • This study confirms that multiple internal thoracic artery grafting significantly improves patient outcomes after coronary artery bypass grafting.
    • Multiple ITA grafting provides substantially greater benefits compared to single ITA grafting alone.
    • Increased utilization of multiple ITA grafting is encouraged to minimize long-term cardiac event risks and associated costs.