Is right coronary artery chronic total vessel occlusion impacting the surgical revascularization results of patients with multivessel disease? A retrospective study

PeerJ

article

Janusz Konstanty-Kalandyk¹  Krzysztof Bartuś¹  Jacek Piątek¹  Anna Kędziora¹  Tomasz Darocha¹  Krzysztof L. Bryniarski²  Marcin Wróżek¹  Piotr Ceranowicz³  Stanisław Bartuś⁴  Leszek Bryniarski⁵  Bogusław Kapelak¹ 

[1] Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, The John Paul II Hospital;Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, The John Paul II Hospital;Department of Physiology, Jagiellonian University Medical College;2nd Department of Cardiology, Jagiellonian University Medical College, The University Hospital;1st Department of Cardiology, Interventional Electrocardiology, and Arterial Hypertension, Jagiellonian University Medical College, The University Hospital

关键词: Coronary artery disease;    Chronic total occlusion;    Surgical revascularization;    Short-term outcome;    CABG;    MACE;   

DOI  :  10.7717/peerj.4909

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Introduction Chronic total occlusion (CTO) is common in the presence of other significantly narrowed coronary arteries. The impact of total occlusion and its association with completeness of revascularization on patients with multivessel disease undergoing coronary artery bypass graft (CABG) remains largely unknown. Aim The aim of our study was to compare CABG operation characteristics, as well as 30-day mortality, incidence of post-operative major adverse cardiac and cerebrovascular events (MACCE) between patients with and without CTO in right coronary artery (RCA). Materials and Methods A total of 156 consecutive patients were included in the analysis. CTO of RCA or right posterior descending artery (RPD) was diagnosed in 57 patients (CTO-RCA group). Coronary stenosis without CTO in RCA was diagnosed in 99 patients (nonCTO-RCA group). Baseline characteristics were comparable in both groups. Results The majority of patients had class II (49.1% vs. 46%, p = 0.86) or class III (42.1% vs. 43%, p = 1.0) Canadian Cardiovascular Society grading system symptoms. Patients in the CTO-RCA group had in average 2.2 grafts implanted, as opposed to 2.4 grafts in patients in the nonCTO-RCA group (p = 0.003). Graft to the RCA was performed in 40.3% patients in the CTO-RCA group and in 81% patients in the nonCTO-RCA group (p = 0.001). The 30-day mortality from any cause or cardiac cause did not differ between groups (7% vs. 2%, p = 0.14 and 3.5% vs. 2%, p = 0.57 respectively). In a multivariate analysis CTO in RCA or RPD and peripheral artery disease were independent predictors of post-operative MACCE (7.9 (1.434–43.045) p = 0.02; 18.8 (3.451–101.833) p < 0.01, respectively). Conclusions Chronic total occlusion of RCA was found to be associated with smaller number of grafts performed during the CABG procedure. Although mortality between patients in the CTO-RCA and nonCTO-RCA groups did not differ, patients in the CTO-RCA group had higher incidence of post-operative MACCE.

【 授权许可】

CC BY