One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

AimsTo investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR).Methods and resultsWe randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional revascularization (CR) using left ITA and vein grafts. The primary angiographic outcome was the patency index: number of patent grafts (<50 stenosed) divided by number of constructed grafts. One-year angiography was complete for 83 of patients. Mean patency index (±SD) was 87 ± 22 in the TAR group and 88 ± 18 in the conventional group (P = 0.52). In 72 of TAR patients and 67 of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23) TAR patients and 43 (25) conventional group patients suffered cardiac events (HR 1.09, 95 CI 0.70-1.69, P = 0.70). One patient (0.6) in the TAR group and two (1.2) in the conventional group died (P = 1.00).ConclusionWithin 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained or superior results of TAR can justify a more general use.