INTRODUCTION: Chronic total occlusion (CTO) in the right coronary artery (RCA) is common in multivessel coronary artery disease. The impact of bypass grafting in the small target vessel (1.0-1.5 mm) of the RCA-CTO on outcomes is unknown. METHODS: RCA-CTO was treated with either bypass grafting (RCA-bypass group) or non-bypass grafting (non-RCA-bypass group). The study compared the shortand long-term outcomes of patients who underwent coronary artery bypass grafting with or without the bypass grafting located in the small target vessel of the RCA-CTO. RESULTS: A total of 426 patients were enrolled in the present study, including 376 patients in the RCA-bypass group and 50 patients in non-RCA-bypass group. The 30-day all-cause death in the RCA-bypass and non-RCA-bypass groups was 2.39% and 2.0% (P=0.999), respectively. The median follow-up time was 73 months. The long-term major adverse cardiac and cerebrovascular events in the RCA-bypass and non-RCA-bypass groups were 6.91% and 18% (P=0.013), respectively. There was a trend toward a higher rate of long-term freedom from major adverse cardiac and cardiovascular events within the RCA-bypass group (log-rank P=0.088). CONCLUSIONS: The bypass grafting located in the small target vessel of the RCA-CTO did not affect the short-term outcomes, but it was associated with a reduced risk of long-term major adverse cardiac and cardiovascular events in patients who underwent coronary artery bypass grafting.
Liu et al. (Wed,) studied this question.