Sequential versus Target graft Coronary Artery Bypass Grafting (Short outcomes)

Background: Coronary artery bypass grafting (CABG) provides a higher chance of survival in comparison with medical treatment for cases with unstable angina and left ventricular (LV) dysfunction. Aim and objective: To compare sequential and conventional CABG techniques according to morbidity, mortality, and surgical post-operative short outcomes. Patients and methods: This prospective, randomized trial was performed on sixty (60) cases of multivessel coronary artery diseases who underwent CABG at Al-Azhar University Hospitals in June 2021 and July 2023. Patients were separated into two groups: Group A (30 patients) submitted for sequential CABG, and Group B (30 cases) submitted for conventional CABG. Results: There was a highly statistically significant variance (p-value < 0.001) among groups under investigation according to total operative time and a statistically significant variance (p-value = 0.007) as regards the number of grafts, although there was no significant variance in postoperative complications, hospital stay, EF at discharge, or 90-day outcome among groups under investigation according to CPB time, cross-clamp time, postoperative hospital complications, and EF at discharge. Conclusion: The selection of surgical techniques is supposed to be guided by the preferences of case surgeons, as both surgery techniques offer distinct benefits in terms of safety and efficacy. In order to enhance long-term patency and diminish perioperative adverse events, experienced surgeons should perform sequential saphenous vein grafts. Sequential SVG grafts may be a viable alternative as a second graft in CABG in certain clinical situations.