Left ventricular recovery after total arterial coronary artery bypass grafting versus conventional coronary artery...

Area of Science:

• Cardiovascular Surgery
• Cardiac Function Assessment
• Coronary Artery Disease Management

Background:

• Multivessel coronary artery disease (CAD) with reduced left ventricular ejection fraction (LVEF) presents a significant clinical challenge.
• Optimizing left ventricular function recovery post-revascularization is crucial for patient outcomes.

Purpose of the Study:

• To compare the efficacy of total arterial revascularization (TAR) versus conventional revascularization (CR) in enhancing left ventricular function recovery.
• To evaluate secondary outcomes including mitral valve regurgitation and graft patency in patients with reduced LVEF.

Main Methods:

• Retrospective cohort study of 162 patients with multivessel CAD and reduced LVEF undergoing isolated coronary artery bypass grafting.
• Left ventricular function assessed via echocardiography (LVEF, global longitudinal peak strain, volumes) at multiple time points up to 12 months.
• Mitral valve regurgitation and graft patency evaluated at 1-year follow-up.

Main Results:

• The TAR group demonstrated significantly greater improvement in LVEF and global longitudinal peak strain compared to the CR group.
• TAR was associated with a lower incidence of mitral valve regurgitation and superior graft patency rates at 12 months.
• No significant differences were observed in hospital mortality or repeat revascularization rates between the two groups.

Conclusions:

• Total arterial revascularization is associated with superior recovery of left ventricular function in patients with multivessel CAD and reduced LVEF.
• These findings suggest TAR may be a preferred revascularization strategy for this high-risk population.
• Further prospective studies are warranted to validate these outcomes.