Abstract
Objectives : 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.
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.
Univariable and multivariable analyses were developed to detect if any
definition was a predictor of perioperative and long-term outcomes.
Results: Complete functional revascularization was a predictor
of increased survival (HR 0.47 CI95: 0,226-0,969; p=0.041). 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 need for revascularization
Conclusions: An uniformly accepted definition of complete
coronary revascularization is lacking. This research raises awareness
about the importance of viability guidance for CABG.