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Long-term outcomes of percutaneous revascularization for internal mammary artery–left anterior descending artery bypass failure

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Abstract

Despite the excellent long-term results of internal mammary artery (IMA)–left anterior descending (LAD) bypass, percutaneous revascularization of IMA is sometimes required for IMA-LAD bypass failure. However, its clinical outcomes have not been fully elucidated. The aim of this study was to investigate the long-term clinical outcomes, including target lesion revascularization (TLR) following contemporary percutaneous revascularization of failed IMA bypass graft. We examined data of 59 patients who had undergone percutaneous revascularization of IMA due to IMA-LAD bypass failure at nine hospitals. Patients with IMA graft used for Y-composite graft or sequential bypass graft were excluded. The incidence of TLR was primarily examined, whereas other clinical outcomes including cardiac death, myocardial infarction, and target vessel revascularization were also evaluated. Mean age of the enrolled patients was 67.4 ± 11.3 years, and 74.6% were men. Forty patients (67.8%) had anastomotic lesions, and 17 (28.8%) underwent revascularization within three months after bypass surgery. Procedural success was achieved in 55 (93.2%) patients. Stent implantation was performed in 13 patients (22.0%). During a median follow-up of 1401 days (interquartile range, 282–2521 days), TLR was required in six patients (8.5% at 1, 3, and 5 years). Patients who underwent percutaneous revascularization within 3 months after surgery tended to have a higher incidence of TLR. Clinical outcomes of IMA revascularization for IMA-LAD bypass failure were acceptable.

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Authors and Affiliations

  1. Cardiovascular Center, Anjo Kosei Hospital, 28 Higashi-Hirokute, Anjo-cho, Anjo, 446-8602, Japan

    Shogo Yamaguchi, Yusuke Uemura, Kenji Takemoto & Masato Watarai

  2. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Akihito Tanaka, Nobutaka Kudo & Toyoaki Murohara

  3. Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan

    Kensuke Takagi & Itsuro Morishima

  4. Department of Cardiology, Toyota Kosei Hospital, Toyota, Japan

    Taiki Ohashi & Yosuke Tatami

  5. Department of Cardiology, Konan Kosei Hospital, Konan, Japan

    Miho Tanaka & Yasunobu Takada

  6. Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan

    Norio Umemoto & Kiyokazu Shimizu

  7. Department of Cardiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Ruka Yoshida & Yukihiko Yoshida

  8. Department of Cardiology, Okazaki Municipal Hospital, Okazaki, Japan

    Yosuke Negishi & Toshikazu Tanaka

  9. Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan

    Makoto Iwama & Toshiyuki Noda

  10. Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Kensuke Takagi

  11. Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan

    Hideki Ishii

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  1. Shogo Yamaguchi
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Correspondence to Yusuke Uemura.

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Conflict of interest

Hideki Ishii received lecture fees from Astellas Pharma Inc., Astrazeneca Inc., Daiichi-Sankyo Pharma Inc., and MSD K. K. Yusuke Uemura received lecture fees from Otsuka Pharma Ltd. Toyoaki Murohara received lecture fees from Bayer Pharmaceutical Co., Ltd., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Pfizer Japan Inc., Sanofi-aventis K. K., and Takeda Pharmaceutical Co., Ltd. Toyoaki Murohara received unrestricted research grant for Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofi-aventis K. K., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Yamaguchi, S., Uemura, Y., Tanaka, A. et al. Long-term outcomes of percutaneous revascularization for internal mammary artery–left anterior descending artery bypass failure. Heart Vessels 38, 157–163 (2023). https://doi.org/10.1007/s00380-022-02150-8

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