AMI-PONT PROSPECTIVE RANDOMIZED CLINICAL TRIAL FOR ANTEROLATERAL TERRITORY CORONARY ARTERY BYPASS GRAFTING STRATEGIES

BackgroundThe main objective of the AMI-PONT trial was to assess whether a CABG strategy including bridge distribute LIMA outflow provides non-inferior patency rates compared conventional surgery with separated graft LAD and aorto-coronary SVG other anterolateral targets. The grafting uses short interposed between at least one target, grafted on hood just above anastomosis (almost direct LIMA-LAD connection). This technique is easy implement has several potential advantages distribution flow greater vascular bed, convenience for angioplasty, easier smaller/fragile diseased/intramyocardial targets, use shorter SVG.Methods ResultsThe power analysis based non-inferiority principle, considering (unilateral 5% alpha, 80%). From July 2012 April 2021, 208 patients were randomized (n=105) or (n=103). Patients characteristics comparable mean age 65±8 years, 93% male, 34% diabetics, 22% recent myocardial infarction LVEF 57±9%. underwent isolated cardiopulmonary bypass received 4.2±0.9 grafts/patients 2.2±0.4 territory. There three patient crossovers; data assessed as intention-to-treat. index (i.e., non-occluded) using multislice spiral computed tomography year. no different year (bridge: 91.8% [145/158] vs conventional: 93.6% [160/171]) risk difference 1.8% (90%CI -3.1% 6.7%), which did not cross specified boundary -5%, demonstrating non-inferiority. LIMA-to-LAD (98.7% [74/75] 96.2% [75/78]; p=0.620). Intraoperatively, group exhibited Medistim doppler in pedicle (75±48ml/min 56±33ml/min; p=0.002) required length targets (53±21mm 97±34mm; p<.001). composite outcome death, need coronary intervention 30 days (2.9% [3/105] 6.8% [7/103]; p=0.212).ConclusionThe shows LSVB presents technical cardiac surgeons faced an aging population diffusely diseased target vessels, limited availability suitable conduits ascending aortas. Ten-year clinical follow-up planned. SVG. Methods p=0.212). ConclusionThe