{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T14:58:32Z","timestamp":1775141912517,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>As definitive data from randomized controlled trials comparing the effect on long-term survival of using single internal mammary artery (SIMA) or bilateral internal mammary artery (BIMA) grafting are not yet available, observational studies allow for long-term follow-up in large and representative populations, which might complement the information potentially derived from randomized trials. To compare long-term survival in patients under 70\u2009years of age undergoing SIMA or BIMA grafting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective analysis of 3384 consecutive patients under 70\u2009years undergoing primary isolated coronary artery bypass grafting, performed from 2000 to 2015, in a Portuguese level III Hospital. We identified 2176 and 1208 patients from the study population who underwent SIMA and BIMA grafting, respectively. The primary end point was all-cause mortality at 10 years. We employed inverse probability weighting to restrict confounding by indication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The mean age of the study population was 59.4 (\u00b1 7.6) years, and 567 (16.8%) were females. Inverse probability weighting was effective in eliminating differences in all significant baseline characteristics. Follow-up was 99.88% complete. The median follow-up time was 12.82 (interquartile range, 9.65, 16.74) years: the primary end point of all-cause mortality at 10 years occurred in 463 patients (21.3%) and 166 (13.7%) in the SIMA and BIMA grafting groups, respectively (hazard ratio, 0.78; 95% confidence interval, 0.66\u20130.92; P\u2009=\u20090.004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Bilateral internal mammary grafting is associated with lower long-term mortality than single internal mammary grafting. Moreover, this survival benefit comes at no increased perioperative morbidity or mortality cost.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivac225","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T13:19:54Z","timestamp":1661433594000},"source":"Crossref","is-referenced-by-count":6,"title":["Long-term survival of single versus bilateral internal mammary artery grafting in patients under 70"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-5179","authenticated-orcid":false,"given":"Armando","family":"Abreu","sequence":"first","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8275-5500","authenticated-orcid":false,"given":"Jos\u00e9","family":"M\u00e1ximo","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"given":"Adelino","family":"Leite-Moreira","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"2022102611472162500_ivac225-B1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 esc\/eacts guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"2022102611472162500_ivac225-B2","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/0003-4975(89)90027-1","article-title":"Incidence of atherosclerosis in the internal mammary artery","volume":"47","author":"Sisto","year":"1989","journal-title":"Ann Thorac Surg"},{"key":"2022102611472162500_ivac225-B3","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1056\/NEJM199601253340411","article-title":"Internal-thoracic-artery grafts. 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