Coronary artery bypass grafts to chronic occluded right coronary arteries.

CABG CABG, coronary artery bypass grafting CAD, coronary artery disease CR, complete revascularization CTO, chronic total occlusion EuroSCORE II, European System for Cardiac Operative Risk Evaluation II IQR, interquartile range IR, incomplete revascularization MACCE, major adverse cardiac and cerebrovascular events MI, myocardial infarction PCI, percutaneous coronary intervention RCA, right coronary artery chronic occluded coronary arteries coronary artery bypass grafting coronary artery disease

Journal

JTCVS open
ISSN: 2666-2736
Titre abrégé: JTCVS Open
Pays: Netherlands
ID NLM: 101768541

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 05 01 2021
accepted: 04 06 2021
entrez: 25 8 2022
pubmed: 9 6 2021
medline: 9 6 2021
Statut: epublish

Résumé

The benefit of revascularizing chronically occluded coronary arteries remains debatable, and available long-term outcome reports are sparse. Current guidelines recommend revascularization of chronically occluded arteries only in patients with myocardial ischemia and/or symptoms associated with angina. We investigated outcome of patients with total chronic occlusion of the right coronary artery (RCA) receiving coronary artery bypass grafting (CABG) surgery with and without revascularization of the RCA. We retrospectively analyzed all patients with chronically occluded RCAs receiving CABG with (group 1 = RCA-CABG; n = 487) and without (group 2 = No-RCA-CABG; n = 100) revascularization of the RCA. In total, 587 patients with complete follow-up of a minimum of 6 years were included (92%). In total, 82% in group 1 versus 86% in group 2 were male ( Patients with a chronically occluded RCA undergoing CABG who did not receive an RCA graft showed a significantly reduced long-term survival. Given the herein presented data, revascularization of chronically occluded right arteries during CABG should be recommended whenever technically feasible.

Sections du résumé

Background UNASSIGNED
The benefit of revascularizing chronically occluded coronary arteries remains debatable, and available long-term outcome reports are sparse. Current guidelines recommend revascularization of chronically occluded arteries only in patients with myocardial ischemia and/or symptoms associated with angina. We investigated outcome of patients with total chronic occlusion of the right coronary artery (RCA) receiving coronary artery bypass grafting (CABG) surgery with and without revascularization of the RCA.
Methods UNASSIGNED
We retrospectively analyzed all patients with chronically occluded RCAs receiving CABG with (group 1 = RCA-CABG; n = 487) and without (group 2 = No-RCA-CABG; n = 100) revascularization of the RCA. In total, 587 patients with complete follow-up of a minimum of 6 years were included (92%).
Results UNASSIGNED
In total, 82% in group 1 versus 86% in group 2 were male (
Conclusions UNASSIGNED
Patients with a chronically occluded RCA undergoing CABG who did not receive an RCA graft showed a significantly reduced long-term survival. Given the herein presented data, revascularization of chronically occluded right arteries during CABG should be recommended whenever technically feasible.

Identifiants

pubmed: 36003729
doi: 10.1016/j.xjon.2021.06.007
pii: S2666-2736(21)00156-X
pmc: PMC9390466
doi:

Types de publication

Journal Article

Langues

eng

Pagination

169-179

Informations de copyright

© 2021 The Authors.

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Auteurs

Maleen Fiddicke (M)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Felix Fleissner (F)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Tonita Brunkhorst (T)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Eva M Kühn (EM)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Doha Obed (D)

Department of Plastic- and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.

Dietmar Boethig (D)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Issam Ismail (I)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Axel Haverich (A)

Department of Cardiothoracic-, Transplantation- and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Gregor Warnecke (G)

Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.

Wiebke Sommer (W)

Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.

Classifications MeSH