NEW ORLEANS — January 31, 2026 — A groundbreaking study presented at the 2026 Society of Thoracic Surgeons Annual Meeting has revealed that two prevalent coronary artery bypass grafting (CABG) strategies offer comparable long-term survival rates. The research, utilizing over 15 years of data from the STS Adult Cardiac Surgery Database (ACSD), highlights key differences based on patient age, providing new insights into optimal treatment approaches.
The study, led by Dr. Thomas Schwann of Corewell Health William Beaumont University Hospital, is the largest of its kind in the United States, comparing the effectiveness of bilateral internal thoracic artery (BITA) and single internal thoracic artery plus radial artery (SITA+RA) strategies. Drawing from data between 2008 and 2023, the analysis included more than 2.1 million CABG patients, with a focus on over 172,000 who underwent multi-arterial bypass grafting.
Key Findings from the Study
Through rigorous propensity-score matching and risk adjustment, the study assessed long-term survival, extending up to 15 years, using data linked with the Centers for Disease Control and Prevention’s National Death Index and Centers for Medicare & Medicaid Services claims databases. The findings were significant:
- Equivalent 15-year survival between BITA and SITA+RA strategies overall
- Improved survival with BITA in patients younger than 60 years
- Lower mortality with SITA+RA in patients aged 70 years and older
- Early (0–5 year) survival advantage for SITA+RA, with BITA trending toward benefit beyond 10 years
- Additional survival benefit when a third arterial conduit was used, regardless of strategy
Importantly, the study documented a steady increase in multi-arterial CABG use across the U.S., rising from approximately 9% to more than 16% over the past decade, primarily driven by the growth in SITA+RA use.
Expert Insights and Implications
Dr. Schwann emphasized the study’s significance, stating, “These findings underscore the power of the STS National Database to answer clinically meaningful questions that randomized trials have struggled to resolve.” He added, “In a contemporary, real-world U.S. population, we found that both BITA and SITA plus radial artery strategies provide excellent long-term outcomes.”
The research suggests that patient age and life expectancy should guide the choice of multi-arterial bypass strategy, rather than a one-size-fits-all approach. “Given the improved survival associated with additional arterial grafts beyond two, this should encourage and challenge surgeons to use as many arterial grafts as possible to optimize outcomes,” Dr. Schwann noted.
Broader Context and Future Directions
The announcement comes as multi-arterial grafting gains broader adoption, providing actionable insights for surgeons navigating conduit selection in multivessel coronary artery disease. The study’s findings are expected to stimulate significant discussion at the 2026 STS Annual Meeting and may influence future clinical guidelines, quality initiatives, and shared decision-making with patients.
The Society of Thoracic Surgeons, a not-for-profit organization representing over 8,000 surgeons, researchers, and allied healthcare professionals worldwide, continues to play a pivotal role in improving outcomes for patients undergoing cardiothoracic surgery. This latest research underscores the organization’s commitment to advancing the field through robust data analysis and evidence-based practices.
