Physiological impact of coronary artery bypass surgery on chronic total occlusion: a functional evaluation using coronary flow reserve

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ID: 329431
2026
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Ranked #114 of 147 articles by views in Interdisciplinary CardioVascular and Thoracic Surgery

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Abstract
Abstract Aims This study evaluated the physiological impact of CABG for left anterior descending (LAD) artery chronic total occlusion (CTO) using postoperative coronary flow reserve (CFR). Methods We retrospectively analyzed 1,149 patients undergoing isolated CABG, comparing LAD-CTO (n = 164) and non-CTO (n = 985) groups. Postoperative CFR was measured in 685 patients. The CTO group was stratified by preoperative Rentrop collateral classification. Results In the entire cohort (n = 1,149), early mortality (3.7% vs. 1.7%, p = 0.1018) and LAD graft patency (97.8% vs. 98.6%, p = 0.4595) were comparable between groups. In the CFR cohort (n = 685), the CTO group showed lower CFR values than the non-CTO group (2.76 ± 0.90 vs. 3.04 ± 0.88, p = 0.0012). However, mean CFR exceeded 2.0 across all CTO subgroups, regardless of collateral status (Poor: 2.66 ± 0.7; Moderate: 2.76 ±0.94; Good: 2.78 ± 1.00; p = 0.763). Conclusions CABG achieves reliable physiological improvement (CFR > 2.0) and favorable outcomes for LAD-CTO revascularization, independent of preoperative Rentrop collateral grade.
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openalex_W7214063688 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors
Journal Interdisciplinary CardioVascular and Thoracic Surgery
Year 2026
DOI
10.1093/icvts/ivag273
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