Remote results of various strategies of coronary bypass surgery (a retrospective pseudorandomized study)

• Bazylev V.V.
• Tungusov D.S.
• Nachkebiya B.R.
• Mikulyak A.I.
• Voevodin A.B.

Abstract

We evaluated multiple (use of both internal thoracic arteries) and single (use of one internal thoracic artery and the great saphenous vein) autoarterial bypass grafting in patients with an isolated lesion of the basin of the left coronary artery. In order to compare patients, we performed propensity score matching by the parameters having differences. Thus, the study consisted of two groups of patients: Group 1 (n=521) subjected to total myocardial revascularization using both internal thoracic arteries and Group 2 (n=521) undergoing shunting using one internal thoracic artery and the great saphenous vein. For differential diagnosis of relapse of angina pectoris in the remote period, coronary bypass angiography was performed in 169 patients. Occlusion of arterial shunts during a follow-up period of up to 13 years was revealed in 35 (14.3%) patients and that of venous shunts in 27 (30%) patients (log-rank = 0.043). With the help of a telephone survey or the data of repeat visits to the polyclinic, we assessed survival of patients after coronary bypass surgery. In the remote period, 56 (11%) Group 1 patients and 72 (14%) Group 2 patients died of cardiovascular pathology (log-rank = 0.045). Over the 13-year follow-up, acute cerebral circulation disorders were diagnosed in 31 (6%) and 35 (7%) cases in Group 1 and Group 2, respectively (log-rank = 0.456). The obtained findings suggest that multiple autoarterial bypass grafting ensures better results of coronary revascularization in the remote period of follow-up.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Bazylev V.V.; data collection and handling – Nachkebiya B.R.; statistical processing – Voevodin A.B.; draft manuscript preparation – Mikulyak A.I.; manuscript revision – Tungusov D.S.

For citation: Bazylev V.V., Tungusov D.S., Nachkebiya B.R., Mikulyak A.I., Voevodin A.B. Remote results of various strategies of coronary bypass surgery (a retrospective pseudorandomized study). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2024; 30 (2): 43–8. DOI: https://doi.org/10.33029/1027-6661-2024-30-2-43-48

Keywords: coronary artery surgery; propensity score matching; remote results