{"id":22192,"date":"2017-10-12T22:20:19","date_gmt":"2017-10-12T16:50:19","guid":{"rendered":"https:\/\/cardiophile.org\/?p=22192"},"modified":"2017-10-12T22:20:19","modified_gmt":"2017-10-12T16:50:19","slug":"multiple-arterial-grafts-rima-lima-give-better-long-term-results","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/","title":{"rendered":"Multiple arterial grafts give better long term results"},"content":{"rendered":"<h1><span style=\"color: #008000;\">Multiple arterial grafts give better long term results<\/span><\/h1>\n<p>A Canadian study [1] published in\u00a0<em>JAMA Cardiology\u00a0<\/em>has shown lower long term mortality, repeat revascularization, myocardial infarction and heart failure in patients receiving multiple arterial grafts as compared to those single <a href=\"https:\/\/johnsonfrancis.org\/professional\/left-subclavian-angiogram-to-visualise-lima\/\">LIMA<\/a> (left internal mammary artery) graft along with SVG (saphenous vein grafts). Of over twenty thousand patients with triple vessel or left main disease who underwent CABG (coronary artery bypass graft), about 5600 received multiple arterial grafts and around 14500 received LIMA graft along with SVG. Subgroup analyses showed that the benefits were consistent in those with diabetes mellitus, obesity, moderate left ventricular systolic dysfunction, COPD (chronic obstructive pulmonary disease), peripheral arterial disease and kidney disease. <em>Additional<\/em> b<em>enefit of multiple arterial grafting could not be demonstrated in the subgroup with severe left ventricular dysfunction<\/em>. Median follow up period was 9.1 years, with an interquartile range of 5.1-12.6 years for those who received multiple arterial grafts. For those who received LIMA + SVG, it was 8.1 (4.5-11.7) years. Reduced mortality and repeat revascularization was demonstrated in a 15 year follow up while reduced myocardial infarction and heart failure was demonstrated in 7 year follow up. Authors recommend consideration of multiple arterial revascularization for all suitable candidates undergoing CABG.<\/p>\n<p>Though 30 day adverse events were similar in both groups, a higher incidence of sternal reconstruction at 180 days was noted in the multiple arterial revascularization group using RIMA + LIMA. But this was not seen in those receiving radial artery graft instead of RIMA.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Pu A, Ding L, Shin J, Price J, Skarsgard P, Wong DR, Bozinovski J, Fradet G, Abel JG. Long-term Outcomes of Multiple Arterial Coronary Artery Bypass Grafting. A Population-Based Study of Patients in British Columbia, Canada. JAMA Cardiol. 2017 Nov 1;2(11):1187-1196. . [<a href=\"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2657318\">Free full text]<\/a>]<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Multiple arterial grafts give better long term results A Canadian study [1] published in\u00a0JAMA Cardiology\u00a0has shown lower long term mortality, repeat revascularization, myocardial infarction and heart failure in patients receiving multiple arterial grafts as compared to those single LIMA (left internal mammary artery) graft along with SVG (saphenous vein grafts). Of over twenty thousand patients [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":33384,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[22],"tags":[584,910,911,2117,2177,2193,3400,3418,4041],"class_list":["post-22192","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiac-surgery","tag-cabg","tag-coronary-artery-bypass-graft","tag-coronary-artery-bypass-grafting","tag-left-main-disease","tag-lima","tag-lita","tag-rima","tag-rita","tag-triple-vessel-disease"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Multiple arterial grafts (RIMA + LIMA) give better long term results<\/title>\n<meta name=\"description\" content=\"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Multiple arterial grafts (RIMA + LIMA) give better long term results\" \/>\n<meta property=\"og:description\" content=\"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2017-10-12T16:50:19+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Multiple arterial grafts give better long term results\",\"datePublished\":\"2017-10-12T16:50:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/\"},\"wordCount\":293,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"CABG\",\"coronary artery bypass graft\",\"Coronary artery bypass grafting\",\"left main disease\",\"LIMA\",\"LITA\",\"RIMA\",\"RITA\",\"triple vessel disease\"],\"articleSection\":[\"Cardiac Surgery\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/\",\"name\":\"Multiple arterial grafts (RIMA + LIMA) give better long term results\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2017-10-12T16:50:19+00:00\",\"description\":\"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Multiple arterial grafts give better long term results\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Multiple arterial grafts (RIMA + LIMA) give better long term results","description":"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/","og_locale":"en_US","og_type":"article","og_title":"Multiple arterial grafts (RIMA + LIMA) give better long term results","og_description":"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.","og_url":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2017-10-12T16:50:19+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"Multiple arterial grafts give better long term results","datePublished":"2017-10-12T16:50:19+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/"},"wordCount":293,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#primaryimage"},"thumbnailUrl":"","keywords":["CABG","coronary artery bypass graft","Coronary artery bypass grafting","left main disease","LIMA","LITA","RIMA","RITA","triple vessel disease"],"articleSection":["Cardiac Surgery"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/","url":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/","name":"Multiple arterial grafts (RIMA + LIMA) give better long term results","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#primaryimage"},"thumbnailUrl":"","datePublished":"2017-10-12T16:50:19+00:00","description":"Multiple arterial grafts using both left and right internal mammary arteries (RIMA + LIMA) give better long term results. Higher sternal reconstruction.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/multiple-arterial-grafts-rima-lima-give-better-long-term-results\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"Multiple arterial grafts give better long term results"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/22192","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=22192"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/22192\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=22192"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=22192"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=22192"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}