{"doi":"10.1016/j.xjon.2022.01.011","title":"Commentary: Long-term outcomes after internal thoracic artery grafting: Where does the time go?","abstract":"Central MessageWho decides how we treat coronary artery disease? Do they have information to make the decision? Are they using it?See Article page 106. Who decides how we treat coronary artery disease? Do they have information to make the decision? Are they using it? See Article page 106. The continued evolution of cardiothoracic surgery and cardiology requires a constant reassessment of long-term outcomes. The debate over the most appropriate treatment for coronary artery disease continues; however, several populations have been identified as having the greatest benefit through randomized control trials, namely those with 3-vessel disease,1Thuijs D.J. Kappetein A.P. Serruys P.W. Mohr F.W. Morice M.C. Mack M.J. et al.Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial.Lancet. 2019; 394: 1325-1334Abstract Full Text Full Text PDF PubMed Scopus (339) Google Scholar diabetic multivessel disease,2Farkouh M.E. Domanski M. Sleeper L.A. Siami F.S. Dangas G. Mack M. et al.Strategies for multivessel revascularization in patients with diabetes.N Engl J Med. 2012; 367: 2375-2384Crossref PubMed Scopus (1438) Google Scholar low ejection fraction,3Velazquez E.J. Lee K.L. Jones R.H. Al-Khalidi H.R. Hill J.A. Panza J.A. et al.Coronary-artery bypass surgery in patients with ischemic cardiomyopathy.N Engl J Med. 2016; 374: 1511-1520Crossref PubMed Scopus (613) Google Scholar and left main disease.4Shlofmitz E. Généreux P. Chen S. Dressler O. Ben-Yehuda O. Morice M.C. et al.Left main coronary artery disease revascularization according to the SYNTAX Score.Circ Cardiovasc Interv. 2019; 12: e008007Crossref PubMed Scopus (16) Google Scholar Early data on outcomes by Yusuf and colleagues5Yusuf S. Zucker D. Peduzzi P. Fisher L.D. Takaro T. Kennedy J.W. et al.Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the coronary artery bypass graft surgery Trialists Collaboration.Lancet. 1994; 344: 563-570Abstract PubMed Scopus (1827) Google Scholar demonstrated improved mortality out to 12 years in patients who underwent coronary artery bypass grafting (CABG). Loop and colleagues6Loop F.D. Lytle B.W. Cosgrove D.M. Stewart R.W. Goormastic M. Williams G.W. et al.Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events.N Engl J Med. 1986; 314: 1-6Crossref PubMed Scopus (2310) Google Scholar and Cameron and colleagues7Cameron A. Davis K.B. Green G. Schaff H.V. Coronary bypass surgery with internal-thoracic-artery grafts—effects on survival over a 15-year period.N Engl J Med. 1996; 334: 216-219Crossref PubMed Scopus (755) Google Scholar demonstrated improved long-term patency when using the internal thoracic artery (ITA) compared with saphenous vein grafting. Atherosclerosis is rarely seen in the ITA conduit, and it is less susceptible to spasm due to manipulation, likely due to its reactivity to endogenous vasodilators.8Takeuchi K. Sakamoto S. Nagayoshi Y. Nishizawa H. Matsubara J. Reactivity of the human internal thoracic artery to vasodilators in coronary artery bypass grafting.Eur J Cardiothorac Surg. 2004; 26: 956-959Crossref PubMed Scopus (26) Google Scholar These excellent outcomes data have led to practice patterns shifting to favor ITA grafting whenever possible. Ohno9Ohno T. The magnitude of the survival benefit of internal thoracic artery grafting: absolute risk reduction.J Thorac Cardiovasc Surg Open. 2022; 9: 106-111Scopus (2) Google Scholar is to be commended for the thoughtful interpretation of the history and current state of CABG surgery and makes some interesting points about future directions. He describes a survival benefit to CABG with ITA over decades. He draws this conclusion based on the aforementioned studies on specific populations1Thuijs D.J. Kappetein A.P. Serruys P.W. Mohr F.W. 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Young","orcid":"0000-0002-5068-1962","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T00:32:41.290883Z","pmid":"36003464","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}