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Clinical Outcomes of Surgical Revascularization Strategies Guided by Quantitative Flow Ratio in Primary Noncoronary Cardiac Surgery.
Li, Linlin; Zhang, Heng; Rao, Chenfei; Meng, Jian; Zhou, Xingtong; Liu, Chang; Fan, Hongguang.
Afiliación
  • Li L; State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
J Thorac Imaging ; 39(5): 312-318, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38686813
ABSTRACT

PURPOSE:

Information regarding quantitative flow ratio (QFR) usage in coronary artery bypass grafting (CABG) is lacking. We compared the incidence of postoperative long-term adverse cardiovascular and cerebrovascular events after QFR-guided or coronary angiography-guided adult cardiac surgery with concurrent bypass surgery. MATERIALS AND

METHODS:

This study included 432 patients who underwent cardiopulmonary bypass (CPB) at our institution with at least 1 angiographical coronary artery lesion (diameter stenosis 30% to 90%) between January 2015 and January 2016. The QFR of each patient was calculated. Patients who only underwent intraoperative coronary revascularization following the principles of optimal revascularization strategy were assigned to group A. Patients with coronary lesions not meeting the above criteria were placed in group B.

RESULTS:

The average number of distal anastomoses of patients with combined CABG in group B was similar to that in Group A (1.9±1.0 vs. 1.7±0.9; P =0.081). Group A had a shorter CPB duration (114.4±49.2 vs 135.8±55.2 minutes; P <0.001) and shorter aortic cross-clamping time (83.6±36.2 vs 101.1±40.6 minutes; P <0.001). The rates of perioperative mortality and major complications did not differ between groups. Long-term major adverse cardiovascular and cerebrovascular events (MACCEs) were less common in group A than in group B (14.7% vs 29.5%; P <0.001).

CONCLUSIONS:

In primary noncoronary cardiac surgery, despite the similar average numbers of distal anastomoses, the group with target vessels treated using an optimal coronary revascularization strategy presented shorter CPB time and aortic cross-clamping time than the other group. Multivariate analyses also showed a lower incidence of long-term MACCEs.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Thorac Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Thorac Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos