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Heart Surg Forum. 2017 Aug 24;20(4):E132-E138. doi: 10.1532/hsf.1793.

Clinical and Angiographic Outcomes in Coronary Artery Bypass Surgery with Multiple versus Single Distal Target Grafts.

Author information

Royal Alexandra Hospital, Edmonton, Canada.
Division of Cardiology, University of Alberta Hospital, Edmonton, Canada.
Cardiac Surgery, University of Alberta Hospital, Edmonton, Canada.
Cardiovascular Health and Stroke, Strategic Clinical Network, Edmonton, Alberta, Canada.
Faculty of Nursing, University of Alberta Hospital, University of Alberta, Edmonton.
University of Dammam, Dammam, Saudi Arabia.
Department of Critical Care, University of Alberta Hospital, Edmonton, Canada.



Coronary artery bypass grafting (CABG) with multiple distal target (MDT) grafts requires less graft material and reduces cardiopulmonary bypass time; however, there may be a higher incidence of graft failure. A real-world analysis reporting long-term outcomes associated with MDT grafts is lacking.


In 6262 consecutive patients who underwent an isolated first CABG from 2004-2012, patients with MDTs were propensity matched to those with single distal target (SDT) grafts. Logistic regression adjusted for traditional, anatomical, and functional definitions of complete revascularization (CR). Outcomes included 30-day, 1-year, and long-term mortality (median 6.29 years). Results: A total of 549 (8.8%) CABG patients had a MDT graft. CR defined using traditional (96.1% versus 92.0%, P = .005), anatomical (89.0% versus 80.20%, P < .001), and functional (90.7% versus 82.6, P < .001) definitions was more frequent in MDT patients. No significant differences in mortality were observed at 30 days (2% versus 3.3%, P = .18), 1-year (3.8% versus 4.9%, P = .37), or through end of follow-up (18.0% versus 16.6% P = .52) between the MDT and SDT groups, respectively. Similarly, no differences were observed after adjustment for all definitions of CR. Graft failure in MDT and SDT patients was 37.8% and 27.6%, respectively (P = .18).


In a contemporary population-based cohort, no differences in mortality were observed between CABG patients with MDT and SDT grafts. Our findings support the safety of MDT grafts to facilitate CR in patients and when graft material is limited.

[Indexed for MEDLINE]

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