AB070. SOH25_AB_043. Surgical revascularization of the diagonal artery: is this necessary?

Background: Coronary artery bypass grafting (CABG) remains the most performed cardiac surgical procedure worldwide. The diagonal artery is a side branch of the left anterior descending artery. This study aims to establish whether revascularization of the diagonal artery is an omissible step during CABG.

Methods: This single-centre retrospective analysis was conducted between 2016 and 2024. Patients with coronary artery disease who chose CABG as their technique of revascularisation were included. In terms of demographics, the average age of participants was 64.33 years. The control group consisted of patients with less than 50% diagonal artery stenosis.

Results: There were 355 patients included in this study. The study included 29% (n=101) patients with significant diagonal artery stenosis. Of the 101 patients with significant stenosis, 84.2% (n=85) were still alive while 15.8% (n=16) were deceased. This was compared with the control group, of which 10.2% (n=26) of 254 were deceased. Of the 101 patients with diagonal artery stenosis, 15 suffered post-operative complications, the most prevalent of which was atrial fibrillation or a-flutter (occurring in 10 patients). 5 patients required a re-sternotomy, often due to bleeding from the body of the vein graft. One patient required further percutaneous coronary intervention.

Conclusions: It has been proposed that failing to bypass the diagonal artery results in an incomplete CABG, which can lead to potential complications. Our results showed no significant discrepancies in morbidity or mortality between the study and control group, indicating that bypassing the diagonal artery is unnecessary.

Keywords: Coronary artery bypass grafting (CABG); diagonal artery stenosis; mortality; post-operative complications; revascularization