Short- and Long-Term Outcomes of Coronary Artery Bypass Grafting with or without the Bypass Grafting Located in the Chronically Occluded Right Coronary Artery

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.