Related Experiment Video
Updated: Jan 30, 2026

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position
Published on: April 1, 2022
Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years
David P Taggart1, Umberto Benedetto1, Stephen Gerry1
1From the Nuffield Department of Surgical Sciences, John Radcliffe Hospital (D.P.T., B.L.), the Centre for Statistics in Medicine, Botnar Research Centre (S.G., D.G.A.), and the Health Economics Research Centre, Nuffield Department of Population Health (A.M.G.), University of Oxford, Oxford, the School of Clinical Sciences, University of Bristol, and Bristol Royal Infirmary, Bristol (U.B.), the Department of Cardiac Surgery, Royal Infirmary of Edinburgh, Edinburgh (V.Z.), Royal Papworth Hospital, Cambridge (C.C., C.S.), the Department of Cardiac Surgery, Freeman Hospital, Newcastle (S.C.), the Department of Cardiac Surgery, King's College Hospital (J.D.), and Royal Brompton Hospital and Imperial College London (J. Pepper), London, the Department of Cardiac Surgery, Royal Infirmary, Manchester (R.H.), the Department of Cardiac Surgery, University Hospital of Wales, Cardiff (P.O.), the Department of Cardiac Surgery, Royal Sussex County, Brighton (U.T.), and Norwich Medical School, University of East Anglia, and Norfolk and Norwich University Hospital, Norwich (M.F.) - all in the United Kingdom; the Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York Presbyterian Hospital (M.G.), and Mount Sinai St. Luke's (J. Puskas) - both in New York; the Center for Cardiovascular Research and Development, American Heart of Poland (A.B.), and the Department of Cardiac Surgery, Medical University of Silesia (M.D., S.W.), Katowice, and the Department of Cardiac and Thoracic Surgery, Wroclaw Medical University, Wroclaw (M.J.) - all in Poland; the Department of Cardiac Surgery, Austin Health, Melbourne, VIC, Australia (B.B., S.S.); and the Heart Institute of Pernambuco, Recife, Brazil (F.M.).
Bilateral internal-thoracic-artery grafts did not significantly improve 10-year survival compared to single arterial grafts in coronary-artery bypass grafting (CABG) surgery. Further research is needed to confirm benefits of multiple arterial grafts.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Coronary-artery bypass grafting (CABG) is a common surgical procedure to treat coronary artery disease.
- The use of multiple arterial grafts, specifically bilateral internal-thoracic-artery grafts, is being investigated as a potential improvement over single arterial grafts for enhanced long-term patient survival.
Purpose of the Study:
- To evaluate the efficacy of bilateral internal-thoracic-artery grafting compared to single internal-thoracic-artery grafting in patients undergoing CABG surgery.
- To assess the long-term outcomes, including all-cause mortality and a composite of death, myocardial infarction, or stroke, at 10 years post-surgery.
Main Methods:
- A randomized controlled trial was conducted, assigning patients scheduled for CABG to either bilateral or single internal-thoracic-artery grafting.
- Patients could receive additional arterial or vein grafts as needed.
- The primary endpoint was 10-year all-cause mortality; a composite outcome of death, myocardial infarction, or stroke was a secondary endpoint.
Main Results:
- No significant difference in 10-year all-cause mortality was observed between the bilateral-graft group (20.3%) and the single-graft group (21.2%) in an intention-to-treat analysis.
- The composite outcome of death, myocardial infarction, or stroke occurred in 24.9% of the bilateral-graft group versus 27.3% in the single-graft group, with no statistically significant difference.
- While most patients received the assigned graft type, some received single grafts or additional radial-artery grafts, and vital status was unknown for a small percentage at 10 years.
Conclusions:
- Bilateral internal-thoracic-artery grafting did not demonstrate a significant survival advantage over single internal-thoracic-artery grafting at 10 years in patients undergoing CABG.
- Further research is warranted to definitively determine if multiple arterial grafts offer superior outcomes compared to single internal-thoracic-artery grafts in CABG patients.
Related Concept Videos
Thoracic Aorta
Internal Energy
Internal Energy
Internal Receptors
The Thoracic Cage: Sternum
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid...
The Thoracic Cage: Ribs
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...

