Impact of Incomplete Revascularization on Long-Term Survival Based on Revascularization Strategy

This study investigated the impact of complete revascularization (CR) versus incomplete revascularization (IR) on long-term survival in patients who underwent multivessel coronary artery bypass grafting (CABG) with either multiple arterial grafts (MAG) or a single artery with saphenous vein grafts (SAG). The analysis revealed that IR did not negatively affect long-term survival in patients who received MAG but was linked to lower survival rates in those receiving SAG. Specifically, patients with MAG IR had better long-term outcomes than those with SAG IR. Furthermore, CR combined with MAG resulted in better long-term survival compared to CR with SAG. Within the MAG cohort, no significant survival differences were observed among patients with perfect CR, imperfect CR, and IR. However, in the SAG cohort, perfect CR was associated with better survival compared to imperfect CR and IR. The study supports the advantage of MAG over SAG in terms of long-term survival, regardless of CR or IR status. The benefit of MAG may be attributed to better graft patency and reduced progression of atherosclerosis compared to SAG. The results suggest that MAG is preferable even when CR is not achievable. The limitations of this study include potential biases inherent in observational studies and a lack of functional assessment of IR.