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Updated: Jan 17, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Impact of Bilateral and Single Internal Thoracic Artery Bypass Grafting on Postoperative Reverse Remodeling in
Yusuke Misumi1, Daisuke Yoshioka1, Takuji Kawamura1
1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Purpose:
The internal thoracic artery (ITA) has shown increased production of nitric oxide, which has beneficial effects on ventricular remodeling, among conduits of coronary artery bypass grafting (CABG). However, little is known about the impact of bilateral ITA strategy on postoperative left ventricle (LV) reverse remodeling as compared with single ITA, especially in patients with severely impaired LV function.
Methods:
We retrospectively reviewed 126 propensity-matched patients with advanced ischemic cardiomyopathy (ICM) (left ventricular ejection fraction <40%) who underwent isolated multiple CABG utilizing bilateral (BITA group; n = 65) or single (SITA group; n = 61) ITA. The primary endpoint was postoperative reduction in the indexed left ventricular end-systolic volume index (LVESVI). Baseline covariates were adjusted with propensity score-matching.
Results:
At baseline, there were no intergroup differences in LVESVI (78 vs. 78 ml/m2, P = 0.93) and EuroSCORE II score (3.0% vs. 2.8%, P = 0.70). At 6 months post-surgery, the BITA group reduced LVESVI to a greater degree than the SITA group (-33% vs. -17%, P <0.01), resulting in significantly smaller postoperative LVESVI (49 vs. 63 ml/m2, P = 0.03). Multivariable analysis showed that CABG with BITA (P = 0.011) was associated with postoperative LV reverse remodeling.
Conclusion:
In patients with ICM undergoing CABG, the in situ BITA strategy was associated with greater reductions in postoperative LV volume.
