Arterial Grafts for Coronary Bypass
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- Mario Gaudino
- Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York (M.G., A.D.F., L.N.G.).
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- Faisal G. Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, OH (F.G.B.).
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- Umberto Benedetto
- Bristol Heart Institute, University of Bristol, School of Clinical Sciences, UK (U.B.).
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- Antonino Di Franco
- Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York (M.G., A.D.F., L.N.G.).
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- Stephen Fremes
- Schulich Heart Centre, Sunnybrook Health Science, University of Toronto, ON, Canada (S.F., D.Y.T.).
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- David Glineur
- Division of Cardiac Surgery, University of Ottawa Heart Institute, ON, Canada (D.G., J.G., M.R.).
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- Leonard N. Girardi
- Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York (M.G., A.D.F., L.N.G.).
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- Juan Grau
- Division of Cardiac Surgery, University of Ottawa Heart Institute, ON, Canada (D.G., J.G., M.R.).
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- John D. Puskas
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York (J.D.P.).
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- Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, ON, Canada (D.G., J.G., M.R.).
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- Derrick Y. Tam
- Schulich Heart Centre, Sunnybrook Health Science, University of Toronto, ON, Canada (S.F., D.Y.T.).
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- David P. Taggart
- Department of Cardiovascular Surgery, University of Oxford, UK (D.P.T.).
Bibliographic Information
- Other Title
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- A Critical Review After the Publication of ART and RADIAL
Description
<jats:p>Observational and randomized evidence shows that arterial grafts have better patency rates than saphenous vein grafts (SVGs) in coronary artery bypass grafting. Observational studies suggest that the use of multiple arterial grafts is associated with longer postoperative survival, but this must be interpreted in the context of treatment allocation bias and hidden confounders intrinsic to the study designs. Recently, a pooled analysis of 6 randomized trials comparing the radial artery with the SVG as the second conduit and the largest randomized trial comparing the use of single and bilateral internal thoracic arteries have provided apparently divergent results about a clinical benefit with the use of >1 arterial conduit. However, both analyses have methodological limitations that may have influenced their results. At present, it is unclear whether the well-documented increased patency rate of arterial grafts translates into clinical benefits in the majority of patients undergoing coronary artery bypass grafting. A large randomized trial testing the arterial grafts hypothesis (ROMA [Randomized Comparison of the Clinical Outcome of Single Versus Multiple Arterial Grafts]) is underway and will report the results in a few years.</jats:p>
Journal
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- Circulation
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Circulation 140 (15), 1273-1284, 2019-10-08
Ovid Technologies (Wolters Kluwer Health)
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Details 詳細情報について
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- CRID
- 1360298454544832640
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- ISSN
- 15244539
- 00097322
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- Data Source
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- Crossref
