Do chronic total occlusive lesions affect patency of coronary bypass grafts to the right coronary artery?

IF 0.7 Q3 Medicine ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2023-11-01 Epub Date: 2023-10-06 DOI:10.1177/02184923231205967

Kosaku Nishigawa, Tatsuya Horibe, Hideaki Hidaka, Ryosuke Numaguchi, Jun Takaki, Takashi Yoshinaga, Toshihiro Fukui

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Abstract

Objectives: To evaluate the impact of chronic total occlusion (CTO) lesions on the patency of bypass grafts to the right coronary artery territory.

Methods: Two hundred patients undergoing primary isolated coronary artery bypass grafting with revascularization to the right coronary artery territory between April 2015 and July 2022 were retrospectively analyzed. Study patients were divided into two groups according to their right coronary artery lesion: patients with CTO lesions (n = 76) and those without CTO lesions (n = 124). Graft flow of the right coronary artery territory was evaluated by intraoperative transit time flow measurement and patency of the bypass graft was evaluated by multidetector row computed tomography.

Results: A total of 200 patients (76 patients with CTO and 124 patients without CTO) were included in this study. Intraoperative transit time flow measurement demonstrated that there was no significant difference in the median mean graft flow (30 ml/min vs. 25 ml/min; p = 0.114), pulsatility index (2.1 vs. 2.4; p = 0.079), and diastolic filling rate (65% vs. 64%; p = 0.844) between patients with CTO and those without CTO. Postoperative multidetector row computed tomography demonstrated that the patency of bypass grafts to the right coronary artery territory was similar between the groups (94.7% in patients with CTO vs. 96.0% in those without CTO; p = 0.733). In patients with CTO, the patency of bypass graft tended to be worse in subgroup with rich collateral blood flow (Rentrop grade 3).

Conclusions: Chronic total occlusion lesions do not affect the patency of bypass grafts to the right coronary artery territory.

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慢性完全闭塞性病变会影响冠状动脉旁路移植到右冠状动脉的通畅性吗？

目的：评价慢性完全闭塞（CTO）病变对右冠状动脉旁路移植通畅性的影响。方法：回顾性分析2015年4月至2022年7月期间接受右冠状动脉原发性孤立性冠状动脉搭桥术并血运重建的200名患者。研究患者根据其右冠状动脉病变分为两组：CTO病变患者（n = 76）和无CTO病变者（n = 124）。通过术中传输时间流量测量评估右冠状动脉区域的移植物流量，并通过多探测器行计算机断层扫描评估旁路移植物的通畅性。结果：本研究共纳入200例患者（76例CTO患者和124例非CTO患者）。术中转运时间流量测量表明，移植物平均流量中位数没有显著差异（30 ml/min与25 ml/min；p = 0.114），搏动指数（2.1对2.4；p = 0.079）和舒张充盈率（65%对64%；p = 0.844）。术后多探测器行计算机断层扫描显示，两组之间右冠状动脉旁路移植物的通畅性相似（CTO患者为94.7%，而非CTO患者的通畅率为96.0%；p = 0.733）。在CTO患者中，侧支血流丰富的亚组（Rentrop 3级）的旁路移植的通畅性往往较差。结论：慢性完全闭塞病变不影响旁路移植至右冠状动脉区域的通畅性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Multiple-

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1.30

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0.00%

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期刊介绍： The Asian Cardiovascular and Thoracic Annals is an international peer-reviewed journal pertaining to cardiovascular and thoracic medicine. Besides original clinical manuscripts, we welcome research reports, product reviews, reports of new techniques, and findings of special significance to Asia and the Pacific Rim. Case studies that have significant novel original observations, are instructive, include adequate methodological details and provide conclusions. Workshop proceedings, meetings and book reviews, letters to the editor, and meeting announcements are encouraged along with relevant articles from authors.