Does Reasonable Incomplete Surgical Revascularization Affect Early or Long-Term Survival in Patients With Multivessel Coronary Artery Disease Receiving Left Internal Mammary Artery Bypass to Left Anterior Descending Artery?

• DOI: 10.1161/circulationaha.108.842005
• Publication Date: 2009-09-14T21:55:37Z
• Authors: Ardawan Julian Ra...; Thomas Walther; Volkmar Falk; Joerg Kempfert; Denis Merk; Sven Lehmann; David Holzhey; Friedrich Wilhelm...
• Keywords: Mammary artery; Myocardial Revascularization

Background— The objective was to evaluate the impact of complete revascularization (CR) versus reasonable incomplete surgical (IR) in others than left anterior descending artery territory on early and late survival patients with multivessel coronary disease (CAD). Methods Results— During a 7-year period, 8.806 consecutive CAD affecting proximal or main stem underwent sternotomy for isolated bypass grafting including internal mammary artery-left bypass. A total 936 (10.6%) had IR circumflex right territory. based traditional classification. Follow-up 3.5±2.2 years. Patient groups were comparable regarding age (CR 67.1 67.6 years), ejection fraction (57.2% 57.5%), logEuroscore (4.5% 4.5%). Patients receiving presented more complex CAD. Mean number distal anastomoses 3.0±0.8 CR 2.4±0.6 IR. Operation time (176 187 minutes) cross-clamp (52 56 longer group ( P <0.001). Hospital mortality 3.3% 3.2% =0.520). Independent risk factors hospital age, pulmonary hypertension, chronic obstructive disease, peripheral vascular emergency indication, but not =0.922). Arterial protective. Cumulative at 1-year 93.1% 93.6% 5 years 82.2 80.9% =0.457). Conclusions— In presence artery-to-left bypass, did adversely affect long-term presenting 1 poor target vessel; however, is good therapeutic option benefit should be balanced against risks.