Isolated left anterior descending artery bypass grafting as incomplete revascularization in multivessel coronary artery disease

Objective. To evaluate safety and feasibility of isolated anterior descending artery bypass grafting in patients with coronary artery disease, multivessel coronary lesion and impossible revascularization of other coronary vessels. Material and methods. The main group included 60 patients who underwent isolated anterior descending artery bypass grafting (incomplete revascularization). The control group included 80 patients who underwent multiple coronary artery bypass grafting and complete myocardial revascularization. Results. In-hospital mortality was absent in both groups. Acute heart failure was more common after incomplete revascularization. Cumulative 11-year survival was 82.5% and 89.5%, respectively (p=0.455). Freedom from adverse cardiac events was 58.1% and 86.5%, respectively (p=0.037). Most of QoL parameters assessed by SAQ questionnaire were higher after complete myocardial revascularization. Conclusion. Incomplete revascularization with isolated anterior descending artery bypass grafting in patients with multivessel coronary disease is not accompanied by higher in-hospital mortality compared to multiple coronary artery bypass grafting and complete myocardial revascularization. However, this approach may be associated with higher risk of acute heart failure. There were no significant between-group differences in 11-year survival. At the same time, higher freedom from adverse cardiac events and lower absolute number of these complications, as well as higher quality of life indicate the advantage of complete myocardial revascularization in achieving the expected result of surgery.