Impact of Bilateral versus Single Internal Thoracic Artery Grafting on the Long-Term Survival in Adults: A Systematic Review

Figures & data

Figure 1 PRISMA flow diagram.

Note: Adapted from Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. ⁵

Table 1 Overview of Studies Analyzed Reporting Mortality, Sternal Complications and Major Adverse Events After Single (SITA) or Bilateral Internal Thoracic Artery Grafting (BITA) According to the Postoperative Follow-Up

Author (Year) [Ref.] Country	Sample Size (Male Gender)	Study Design	Mean Follow-Up	Variables	SITA	BITA	p-value
Taggart (2010)^Citation6 UK	3102 (85.6%)	RCT	1 year	Number	1554	1554	–
				Male gender	86.1%	85.1%	–
				Mortality	2.3%	2.5%	NR
				Sternal complication	1.9%	3.5%	0.005
				Sternal Reconstruction	0.6%	1.9%	0.002
				Myocardial infarction	2%	2%	NR
				Stroke	1.8%	1.5%	NR
				Repeat revascularization	1.3%	1.8%	NR
Taggart (2016)^Citation7 UK	3102 (85.6%)	RCT	5 years	Mortality	8.4%	8.7%	0.77
				Myocardial infarction	3.5%	3.4%	0.86
				Stroke	3.2%	2.5%	0.24
				Repeat revascularization	6.6%	6.5%	0.91
Taggart (2019)^Citation8 UK	3102 (85.6%)	RCT	10 years	Mortality	21.2%	20.3%	0.62
				Myocardial infarction	5%	4.6%	NR
				Stroke	4.9%	3.7%	NR
				Repeat revascularization	10%	10.3%	NR
DeSimone (2018)^Citation10 USA	47,984 (74.3%)	Matched cohorts	12 years	Number	1297	1297	–
				Male gender	81%	82%	–
				Early mortality	1.2%	0.8%	0.315
				Mediastinitis	0.9%	0.8%	0.667
Schwann (2018)^Citation11 USA	1,493,470 (70.1%)	Database	NR	Number	1,334,511	73,054	–
				Male gender	73.8%	85.1%	<0.001
				Early mortality	1.91%	1.19%	<0.001
				Mediastinitis	0.73	1.08%	<0.001
Shi (2015)^Citation12 Australia	2821 (80%)	Matched cohorts	NR	Number	591	591	–
				Male gender	88%	88%	–
				Early mortality	0.7%	1.2%	0.55
				Mediastinitis	0.8%	1.7%	0.30
Samadashvili (2019)^Citation13 USA	63,402 (76%)	Matched cohorts	1 year	Number	10,828	10,828	–
				Male gender	82%	83%	–
				Mortality	2.2%	2.4%	0.26
				Myocardial infarction	1.9%	1.6%	0.07
				Stroke	1.7%	1.8%	0.29
				Repeat revascularization	3.5%	2.5%	<0.001
			7 years	Mortality	14.3%	12.7%	<0.001
				Myocardial infarction	6.2%	5.2%	0.006
				Stroke	5.2%	5.4%	0.78
				Repeat revascularization	14.6%	11.7%	<0.001

Notes: p-value < 0.05 = Statistical significance.

Abbreviations: RCT, randomised controlled clinical trial; NR, not reported.

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