• Umberto Benedetto, Mohamed Amrani, Jullien Gaer, Toufan Bahrami, Fabio de Robertis, André R Simon, Shahzad G Raja, and Harefield Cardiac Outcomes Research Group.
• Department of Cardiac Surgery, Harefield Hospital, London, United Kingdom. Electronic address: umberto.benedetto@hotmail.com.
• J. Thorac. Cardiovasc. Surg.. 2014 Dec 1;148(6):2699-705.

ObjectivesWe undertook a single-center, 12 years outcomes analysis of the influence of bilateral internal mammary arteries (BIMA) over single internal mammary artery (SIMA) on short-term outcomes and long-term outcomes by means of propensity score matching technique in accordance to current recommendations.MethodsA propensity score was generated for each patient from a multivariable logistic regression model based on 20 pretreatment covariates. The study population consisted of 4195 patients undergoing coronary artery bypass graft procedure using SIMA (n = 3445; 78.3%) or BIMA (n = 750; 21.7%). A total of 750 matching sets were derived.ResultsThe BIMA group was associated with an increased rate of superficial sternal wound infection (5.6% vs 1.7%; P = .0001) but the incidence of deep sternal wound infection was comparable between the 2 groups, at 2.1% and 1.5% in BIMA and SIMA groups, respectively (P = .43). With regard to other postoperative complications the 2 groups were comparable. Operative mortality rate did not significantly differ between the 2 groups, at 0.7% and 1.2% in the BIMA and SIMA groups, respectively (P = .28). After a mean follow-up time of 4.8 ± 3.2 years, BIMA use was associated with a significantly lower risk for late mortality (hazard ratio, 0.61; 95% confidence interval 0.38-0.97; P = .03) and need for repeat revascularization (hazard ratio, 0.75; 95% confidence interval, 0.53-0.96; P = .03).ConclusionsWhen compared with SIMA grafting, BIMA use did not increase operative morbidity and mortality and was associated with a better long-term survival.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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