ArticleJTCVS open2026
Early and long-term outcomes of bilateral internal mammary artery versus radial artery grafting: A national cohort study.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Objective: To compare early and long-term outcomes of bilateral internal mammary artery (BIMA) grafting versus left internal mammary artery (LIMA) plus radial artery (RA) grafting in patients undergoing isolated coronary artery bypass grafting (CABG). Methods: This retrospective national cohort study included patients undergoing isolated CABG with multiarterial grafting in Uruguay between 2002 and 2022. Patients undergoing BIMA grafting or LIMA+RA grafting were identified from a mandatory national cardiac surgery database. Propensity score matching with multiple imputation was used to balance baseline characteristics between the 2 groups. Long-term survival was assessed using Kaplan-Meier analysis, Cox proportional hazards models, and restricted mean survival time (RMST). Competing-risk regression (Fine-Gray) was used to evaluate repeat percutaneous coronary intervention. Effect modification by sex and diabetes was explored. Results: Among 2882 patients (2132 BIMA and 750 LIMA+RA), 4203 matched (with replacement) patients were analyzed. At 10 years, RMST did not differ between groups (9.06 years for BIMA vs 8.98 years for LIMA+RA; Conclusions: In this national cohort, BIMA grafting improved early outcomes but did not confer a consistent overall long-term survival advantage compared with LIMA+RA grafting. A lack of support from sensitivity analyses implies the need for an individualized approach.
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