No significant difference found at 5-year follow-up between bilateral and single CABG: The ART trial
1. At 5-years of follow-up, there were no significant differences in the rates of mortality and cardiovascular outcomes when comparing patients treated with bilateral or single internal-thoracic-artery coronary-artery bypass grafting (CABG).
2. There was a significantly higher rate of sternal wound complications observed in the bilateral group compared to the single group.
Evidence Rating: 1 (Excellent)
One of the most commonly performed operations for the treatment of symptomatic multivessel coronary artery disease is CABG. The procedure involves an anastomosis of the left internal thoracic (mammary) artery (LIMA) to the left anterior descending (LAD) coronary artery. In cases where grafts are required, saphenous vein or radial artery grafts to bypass the other arteries may be used. The LIMA to LAD approach has resulted in over 90% patency rate at 10 years compared to 50% for vein grafts. This has resulted in the proposal to use a bilateral internal-thoracic-artery approach. However, the complexity of the procedure, higher risk of sternal wound complications, and lack of randomized evidence has hindered its popularity. Hence, the Arterial Revascularization Trial (ART) was initiated to compare the 10-year survival of bilateral compared to single artery grafting. At 5 years of follow-up, there were no significant differences between the two groups in the rates of mortality or cardiovascular events. There was a higher rate of sternal wounds in the bilateral group compared to the single group. The study is limited given that it is an interim analysis of a 10-year project.
来源：《新英格兰医学杂志》N Engl J Med 2016; 375:2540-2549December 29, 2016DOI: 10.1056/NEJMoa1610021
https://www.nejm.org/doi/full/10.1056/NEJMoa1610021
Aliya68
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听友87041364
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