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. 2021 Dec;36(12):4497-4502.
doi: 10.1111/jocs.15986. Epub 2021 Sep 16.

Complete surgical revascularization: Different definitions, same impact?

Paulo Veiga Oliveira  1 , Márcio Madeira  1 , Sara Ranchordás  1 , Marta Marques  1 , Manuel Almeida  2 , Miguel Sousa-Uva  1 , Miguel Abecasis  1 , José Pedro Neves  1
Affiliations

Complete surgical revascularization: Different definitions, same impact?

Paulo Veiga Oliveira et al. J Card Surg. 2021 Dec.

Abstract

Background: There are several different definitions of complete revascularization on coronary surgery across the literature. Despite the importance of this definition, there is no agreement on which one has the most impact. The aim of this study was to evaluate which definition of complete surgical revascularization correlates with early and late outcomes.

Methods: All consecutive patients submitted to isolated CABG from 2012 to 2016 with previous myocardial scintigraphy were evaluated.

Exclusion criteria: emergent procedures and previous cardiac surgery procedures. The population of 162 patients, follow-up complete in 100% patients; median 5.5; IQR: 4.4-6.9 years. Each and all of the 162 patients were classified as complying or not with the four different definitions: numerical, functional, anatomical conditional, and anatomical unconditional. Perioperative outcome: MACCE; long-term outcomes: survival and repeat revascularization. Univariable and multivariable analyses were developed to detect predictors of outcomes.

Results: Complete functional revascularization was a predictor of increased survival (HR: 0.47; CI 95: 0.226-0.969; p = .041). No other definitions showed effect on follow-up mortality. Age and cardiac dysfunction increased long-term mortality. The definition of complete revascularization did not have an impact on MACCE or the need for revascularization CONCLUSIONS: A uniformly accepted definition of complete coronary revascularization is lacking. This study raises awareness about the importance of viability guidance for CABG.

Keywords: CABG; complete revascularization; coronary disease; definition.

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References

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