| Description: |
Objectives . Despite guideline recommendations for use of bilateral internal mammary artery (BIMA) in coronary artery bypass grafting (CABG), a large proportion of patients still receive saphenous vein grafts (SVG). We herein aimed to identify reasons for SVG use at a center with a BIMA utilization rate between 60 and 70% and compare outcomes of patients undergoing CABG with either BIMA or left internal mammary artery (LIMA) plus SVG. Methods . Between 2013 and 2022, 4145 consecutive patients underwent isolated CABG at our center. Of those, 2067 patients received BIMA (group 1) and 1206 patients received LIMA/SVG (group 2). A propensity score‐matched analysis was performed to adjust for baseline differences. Results . Group 2 presented with higher age, more female patients, and more patients with acute coronary syndrome including NSTEMI/STEMI with more urgent/emergency CABG. In unadjusted analysis group 2 presented adverse 30‐day outcomes compared to group 1 with a higher mortality (18/2067, 0.9% vs. 34/1206, 2.8%; p < 0.001), higher rate of re‐revascularization (52/2067, 2.5% vs. 50/1206, 4.1%; p < 0.001), more stroke (20/2067; 1.0% vs. 33/1206, 2.7%; p < 0.001), and more postoperative renal failure (17/2067, 0.8% vs. 27/1206, 2.2%; p = 0.001). After adjustment for baseline characteristics, 30‐day outcomes were comparable. Conclusions . After adjustment for baseline characteristics no differences in outcomes were found between groups suggesting a safe applicability of BIMA even in patients with acute coronary syndrome undergoing urgent/emergency CABG. Reasons for SVG use were higher age, female gender, and acute coronary syndrome with urgent/emergency CABG. Outcomes of both groups were excellent with low rates of primary endpoints. |