Objectives: The aim of the present study was to evaluate the results of isolated coronary artery bypass grafting (CABG) with or without revascularization of the occluded right coronary artery (RCA). Methods: Patients undergoing isolated CABG were included in a prospective European multicenter registry. Outcomes were adjusted for imbalance in preoperative variables with propensity score matching analysis. Late outcomes were evaluated with Kaplan-Meier's method and competing risk analysis. Results: Out of 2,948 included in this registry, 724 patients had a total occlusion of the RCA and were the subjects of this analysis. Occluded RCA was not revascularized in 251 (34.7%) patients with significant variability between centers. Among 245 propensity score-matched pairs, patients with and without revascularization of occluded RCA had similar early outcomes. The nonrevascularized RCA group had increased rates of 5-year all-cause mortality (17.7 vs. 11.7%, p = 0.039) compared with patients who had their RCA revascularized. The rates of myocardial infarction and repeat revascularization were only numerically increased but contributed to a significantly higher rate of MACCE (24.7 vs. 15.7%, p = 0.020) at 5 year among patients with nonrevascularized RCA. Conclusions: In this multicenter study, one-third of totally occluded RCAs was not revascularized during isolated CABG for multivessel coronary artery disease. Failure to revascularize an occluded RCA in these patients increased the risk of all-cause mortality and MACCEs at 5 years.
Id prodotto:
131776
Handle IRIS:
11562/1085464
ultima modifica:
24 febbraio 2024
Citazione bibliografica:
Biancari, Fausto; Dalén, Magnus; Tauriainen, Tuomas; Gatti, Giuseppe; Salsano, Antonio; Santini, Francesco; Feo, Marisa De; Zhang, Qiyao; Mazzaro, Enzo; Franzese, Ilaria; Bancone, Ciro; Zanobini, Marco; Mäkikallio, Timo; Saccocci, Matteo; Francica, Alessandra; Onorati, Francesco; El-Dean, Zein; Mariscalco, Giovanni,
Revascularization of Occluded Right Coronary Artery and Outcome After Coronary Artery Bypass Grafting«THORACIC AND CARDIOVASCULAR SURGEON»
, 2023
, pp. 1-6