Early Outcome of Bilateral Versus Single Internal Mammary Artery Grafting in the Elderly

European Wide Clinical Study on BIMA Outcome (Italy, Germany, Finland, France, Sweden, United Kingdom, Turkey)

A total of 2,899 patients aged 70 years or older were included in this multicenter prospective study between January 2015 and December 2016, 855 patients underwent BIMA grafting and were included in the prospective multicenter Outcome After Coronary Artery Bypass Grafting (E-CABG) study were considered in this analysis.

The BIMA grafting cohort had a significantly increased risk of any sternal wound infection (7.7% versus 5.1%) as well as higher risk of deep sternal wound infection/mediastinitis (4.0% versus 2.2%).

The BIMA grafting cohort required a mean average of 1 day more Intensive care unit stay and 1 more day in-hospital stay.

Bilateral internal mammary artery grafting in elderly patients seems to be associated with a worse early outcome compared with SIMA grafting, particularly in patients undergoing urgent operation. Until more conclusive results are gathered, BIMA grafting should be reserved only for elderly patients with stable coronary artery disease, without significant baseline comorbidities and with long life expectancy.

Link to study: https://pubmed.ncbi.nlm.nih.gov/29410264/

Compare with the Posthorax solution: https://posthorax.net/article?id=42&lng=en