Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

Sune Damgaard; Jens T Lund; Thomas Nikolaj Bang Lilleør; Mario J Perko; Kåre Sander; Blagoja Dimo; Maiken B Jensen; Jan K Madsen; Henning Kelbaek; Daniel A Steinbrüchel

doi:10.1016/j.jtcvs.2007.10.039

Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

Sune Damgaard, Jens T Lund, Thomas Nikolaj Bang Lilleør, Mario J Perko, Kåre Sander, Blagoja Dimo, Maiken B Jensen, Jan K Madsen, Henning Kelbaek, Daniel A Steinbrüchel

9 Citations (Scopus)

Abstract

OBJECTIVE: The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse.

METHODS: In a randomized single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up.

RESULTS: The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0.9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound complications requiring hospitalization: 3 (1.9%) versus 6 (3.5%) (P = .50), respectively.

CONCLUSION: These results confirm previous reports that total arterial revascularization can be performed with low in-hospital morbidity and mortality. Further, in the 3 postoperative months, total arterial revascularization did not lead to more complications or admissions than conventional surgery. Arterial grafting was performed with significantly fewer bypasses, but no differences in anginal status were seen after 3 months. A tendency toward more sternal complications after arterial grafting was observed, but clinical outcomes were comparable to conventional grafting.

Original language	English
Journal	The Journal of Thoracic and Cardiovascular Surgery
Volume	135
Issue number	5
Pages (from-to)	1069-75
Number of pages	7
ISSN	0022-5223
DOIs	https://doi.org/10.1016/j.jtcvs.2007.10.039
Publication status	Published - May 2008

Keywords

Aged
Coronary Artery Bypass/methods
Female
Humans
Internal Mammary-Coronary Artery Anastomosis
Male
Mammary Arteries/surgery
Middle Aged
Saphenous Vein/transplantation
Treatment Outcome

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10.1016/j.jtcvs.2007.10.039

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Damgaard, S., Lund, J. T., Lilleør, T. N. B., Perko, M. J., Sander, K., Dimo, B., Jensen, M. B., Madsen, J. K., Kelbaek, H., & Steinbrüchel, D. A. (2008). Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial. The Journal of Thoracic and Cardiovascular Surgery, 135(5), 1069-75. https://doi.org/10.1016/j.jtcvs.2007.10.039

Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery : Copenhagen Arterial Revascularization Randomized Patency and Outcome trial. / Damgaard, Sune; Lund, Jens T; Lilleør, Thomas Nikolaj Bang et al.

In: The Journal of Thoracic and Cardiovascular Surgery, Vol. 135, No. 5, 05.2008, p. 1069-75.

Research output: Contribution to journal › Journal article › Research › peer-review

Damgaard, S, Lund, JT, Lilleør, TNB, Perko, MJ, Sander, K, Dimo, B, Jensen, MB, Madsen, JK, Kelbaek, H & Steinbrüchel, DA 2008, 'Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial', The Journal of Thoracic and Cardiovascular Surgery, vol. 135, no. 5, pp. 1069-75. https://doi.org/10.1016/j.jtcvs.2007.10.039

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title = "Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial",

abstract = "OBJECTIVE: The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse.METHODS: In a randomized single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up.RESULTS: The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0.9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound complications requiring hospitalization: 3 (1.9%) versus 6 (3.5%) (P = .50), respectively.CONCLUSION: These results confirm previous reports that total arterial revascularization can be performed with low in-hospital morbidity and mortality. Further, in the 3 postoperative months, total arterial revascularization did not lead to more complications or admissions than conventional surgery. Arterial grafting was performed with significantly fewer bypasses, but no differences in anginal status were seen after 3 months. A tendency toward more sternal complications after arterial grafting was observed, but clinical outcomes were comparable to conventional grafting.",

keywords = "Aged, Coronary Artery Bypass/methods, Female, Humans, Internal Mammary-Coronary Artery Anastomosis, Male, Mammary Arteries/surgery, Middle Aged, Saphenous Vein/transplantation, Treatment Outcome",

author = "Sune Damgaard and Lund, {Jens T} and Lille{\o}r, {Thomas Nikolaj Bang} and Perko, {Mario J} and K{\aa}re Sander and Blagoja Dimo and Jensen, {Maiken B} and Madsen, {Jan K} and Henning Kelbaek and Steinbr{\"u}chel, {Daniel A}",

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doi = "10.1016/j.jtcvs.2007.10.039",

language = "English",

volume = "135",

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journal = "Journal of Thoracic and Cardiovascular Surgery",

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T1 - Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery

T2 - Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

AU - Damgaard, Sune

AU - Lund, Jens T

AU - Lilleør, Thomas Nikolaj Bang

AU - Perko, Mario J

AU - Sander, Kåre

AU - Dimo, Blagoja

AU - Jensen, Maiken B

AU - Madsen, Jan K

AU - Kelbaek, Henning

AU - Steinbrüchel, Daniel A

PY - 2008/5

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N2 - OBJECTIVE: The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse.METHODS: In a randomized single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up.RESULTS: The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0.9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound complications requiring hospitalization: 3 (1.9%) versus 6 (3.5%) (P = .50), respectively.CONCLUSION: These results confirm previous reports that total arterial revascularization can be performed with low in-hospital morbidity and mortality. Further, in the 3 postoperative months, total arterial revascularization did not lead to more complications or admissions than conventional surgery. Arterial grafting was performed with significantly fewer bypasses, but no differences in anginal status were seen after 3 months. A tendency toward more sternal complications after arterial grafting was observed, but clinical outcomes were comparable to conventional grafting.

AB - OBJECTIVE: The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse.METHODS: In a randomized single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up.RESULTS: The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0.9 in the conventional group (P = .004). Three months' follow-up for the arterial versus conventional groups showed the following: deaths: 1 (0.6%) versus 0; stroke: 3 (1.9%) versus 3 (1.8%); myocardial infarction: 6 (3.7%) versus 4 (2.4%); sternal wound reoperation: 4 (2.5%) versus 0 (P = .054); arm and leg wound complications requiring hospitalization: 3 (1.9%) versus 6 (3.5%) (P = .50), respectively.CONCLUSION: These results confirm previous reports that total arterial revascularization can be performed with low in-hospital morbidity and mortality. Further, in the 3 postoperative months, total arterial revascularization did not lead to more complications or admissions than conventional surgery. Arterial grafting was performed with significantly fewer bypasses, but no differences in anginal status were seen after 3 months. A tendency toward more sternal complications after arterial grafting was observed, but clinical outcomes were comparable to conventional grafting.

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KW - Coronary Artery Bypass/methods

KW - Female

KW - Humans

KW - Internal Mammary-Coronary Artery Anastomosis

KW - Male

KW - Mammary Arteries/surgery

KW - Middle Aged

KW - Saphenous Vein/transplantation

KW - Treatment Outcome

U2 - 10.1016/j.jtcvs.2007.10.039

DO - 10.1016/j.jtcvs.2007.10.039

M3 - Journal article

C2 - 18455586

SN - 0022-5223

VL - 135

SP - 1069

EP - 1075

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

IS - 5

ER -

Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

Abstract

Keywords

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