{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:18:40Z","timestamp":1788499120348,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The use of in situ internal thoracic artery (ITA) grafts ipsilateral to upper extremity arterio-venous fistulas (UE-AVFs) during coronary artery bypass grafting (CABG) in dialysis-dependent patients raises concerns of coronary steal and compromised graft perfusion. However, the clinical significance of ITA-AVF laterality remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed dialysis-dependent patients who underwent CABG between February 2015 and December 2023 at 2 institutions. Patients with non-UE-AVF access, total vein grafting, or composite vein-artery configurations were excluded. The final cohort (N\u2009=\u2009122) was divided into 2 groups: ipsilateral in situ ITA grafts (N\u2009=\u200966) and contralateral in situ or free ITA grafts (N\u2009=\u200956). The primary outcome was the incidence of major adverse cardiovascular and cerebrovascular events (MACCE); secondary outcomes included perioperative complications, haemodialysis-induced ischaemia, and 3-year survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline and operative characteristics were largely comparable between groups. Perioperative outcomes, including surgical site infection, 30-day mortality, and prolonged ventilation, showed no significant differences. Over a median follow-up of 2.4 years, MACCE occurred in 44% of patients (39% ipsilateral vs 50% contralateral\/free ITA; P\u2009=\u2009.24), with no significant differences in 3-year mortality (29% vs 21%; P\u2009=\u2009.352). Multivariable analyses showed no association between ITA-AVF laterality and MACCE (adjusted odds ratio 0.68, P\u2009=\u2009.31) or 3-year mortality (adjusted hazard ratio 1.56, P\u2009=\u2009.291).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this modestly sized retrospective cohort, ipsilateral in situ ITA grafting was not associated with significantly worse perioperative or long-term outcomes. Our findings should be interpreted as hypothesis-generating, and larger multicentre studies are needed to more definitively evaluate the safety of this grafting strategy in dialysis-dependent patients with UE-AVFs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag231","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:39:15Z","timestamp":1787657955000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical Outcomes of in situ Internal Thoracic Artery Grafting in Patients with Ipsilateral Upper-Extremity Arteriovenous Fistulas"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-1264","authenticated-orcid":false,"given":"Chijioke","family":"Chukwudi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center , Pittsburgh, PA 15213,","place":["United 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