Use of the In Situ Right Internal Thoracic Artery as an Alternative Single-Inflow Source

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Grafting

Background:

• Coronary artery bypass grafting (CABG) is a critical procedure for treating coronary artery disease.
• The internal thoracic artery (ITA) is a preferred graft conduit due to its long-term patency.
• Evaluating alternative ITA sources is essential for optimizing CABG outcomes.

Purpose of the Study:

• To assess the efficacy of the in situ right internal thoracic artery (RITA) as a single-inflow source in CABG.
• To compare RITA composite grafting with the conventional left internal thoracic artery (LITA) composite grafting.
• To determine long-term graft patency and clinical outcomes for RITA-based CABG.

Main Methods:

• A retrospective study comparing 73 patients undergoing CABG with RITA composite grafting (RITA group) versus LITA composite grafting (LITA group).
• 1:1 propensity score matching was employed to create comparable patient cohorts.
• Angiographic patency and clinical outcomes, including reintervention and major adverse cardiac events, were evaluated.

Main Results:

• No significant difference in overall graft patency rates at 1 year (92.2% vs. 92.5%) and 5 years (87.3% vs. 90.4%) between the RITA and LITA groups.
• Cumulative incidences of reintervention and major adverse cardiac events were similar between the two groups.
• Propensity score matching yielded 43 comparable pairs for analysis.

Conclusions:

• The in situ RITA is a viable and effective alternative to the LITA for single-inflow composite grafting in CABG.
• RITA-based composite grafting demonstrates comparable long-term graft patency and clinical outcomes to LITA-based grafting.
• This finding supports the expanded use of RITA in CABG procedures.