After the publication of the interim analysis of the ART, we review the contradiction between the large numbers of observational studies published on the course of over 25 years and the randomized trials comparing the use of single versus multiple arterial grafts for coronary bypass surgery.
The Arterial Revascularization Trial (ART) found no difference in survival and event-free survival at 5 years between patients randomized to receive one or two internal thoracic arteries at the time of surgery.
At the moment, there is evidence that arterial grafts have higher patency rate than venous grafts and a possible protective effect on the coronary circulation. Arterial grafts are still a reasonable choice, especially in patients with long life expectancy. Further studies and the final results of ART are needed.
aDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, New York, USA
bDivision of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
cUniversity of Oxford, United Kingdom
Correspondence to Professor Mario F.L. Gaudino, Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th Street, New York, NY 10065, USA. Tel: +1 212 746 9440; e-mail: firstname.lastname@example.org