OBJECTIVE: Bilateral Internal Thoracic Artery (BITA) grafting is not often used in patient with COPD due to questionable survival benefit and increased risk of sternal infection compared to operations incorporating Single Internal Thoracic Artery (SITA). The purpose of this study is to compare early and long term outcome of COPD patients undergoing BITA grafting to that of patients undergoing coronary artery bypass (CABG) grafting with SITA.
METHODS: We compared one hundred and ninety six COPD patients who underwent BITA grafting with 123 COPD patients who underwent CABG with SITA in our center between 1996 and 2008.
RESULTS: Logistic Euro score of SITA patients was significantly higher (22 ± 4.1 vs.15 ± 3.5, P= < 0.001) as well as higher occurrence of unstable angina (70.4% vs. 56.9%, P=0.010) Insulin treated diabetes (9.2% vs. 3.3%,. P=0.031), age 70+ (54.1% vs. 32.9%, P< 0.001), and Off-Pump CABG (30.1% vs. 20.3%, P= 0.035). Conversely, congestive heart failure (38.2% vs. 25.5%, P= 0.012), was more common among BITA patients.
Operative mortality (6.5% vs 3.1%, BITA vs. SITA), and sternal wound infections (6.1% vs. 9.8.%) were not significantly different between groups. Mean follow-up was 9.25 ± 4.35 years.
Ten year survival (Kaplan-Meier) was similar (55% vs. 51%,BITA and SITA, respectively) Assignment to the BITA group was not associated with better propensity adjusted survival, COX model)
CONCLUSIONS: We conclude that BITA grafting may be utilized in COPD patients. However early outcome and long-term survival are not better than those of patients treated with SITA
