Abstract Objectives: There are several different definitions of complete revascularization on coronary surgery across the literature. Despite the importance of this definition there is no agreement on which one has the most impact. The aim of this study was to evaluate which definition of complete surgical revascularization correlates with early and late outcomes. Methods: All consecutive patients submitted to isolated CABG from 2012 to 2016 with previous myocardial scintigraphy were evaluated. Exclusion criteria: emergent procedures and previous cardiac surgery procedures. Population of 162 patients, follow-up complete in 100% patients; median 5,5 IQR 4,4-6,9 years. Each and all of the 162 patients were classified as complying or not with the four different definitions: Numerical, Functional, Anatomical Conditional and Anatomical unconditional. Univariable and multivariable analyses were developed to detect if any definition was a predictor of perioperative and long-term outcomes. Results: Complete functional revascularization was a predictor of increased survival (HR 0.47 CI95: 0,226-0,969; p=0.041). No other definitions showed effect on follow-up mortality. Age and cardiac dysfunction increased long-term mortality. The definition of complete revascularization did not have an impact on MACCE or need for revascularization Conclusions: An uniformly accepted definition of complete coronary revascularization is lacking. This research raises awareness about the importance of viability guidance for CABG.
Objectives: The aims of this study were to analyze early and late outcomes of TVS and identify predictors of poor prognosis . Methods: Single centre retrospective study with 108 patients who underwent TVS between 2007 and 2016. Most of the patients were female (74.1%), mean age of 65 years; 61,1% were in New York Heart Association class III/IV, with a EuroSCORE II of 7.5%. Univariable and Multivariable analyses were developed to identify predictors of perioperative mortality and morbidity and long-term mortality. Results: In-hospital mortality was 12%. Creatinine clearance was an independent predictor of decreased perioperative mortality. This group had 28.7% rate of major perioperative complications. Systolic pulmonary pressure and obesity were predictors of early morbidity. The 10-year mortality was 29.6%. The survival at 1, 5 and 10 years was 80%, 76% and 45%, respectively. Diabetes Mellitus was a risk factor for long-term mortality and creatinine clearance was a predictor of long-term survival. Need for re-operation was identified in 3.5% of the patients. Conclusions: Patients undergoing TVS have high surgical risk making TVS an operation associated with high mortality and morbidity. This research identifies Diabetes Mellitus, renal function, pulmonary hypertension and obesity as the future challenges in TVS.