Is Myocardial Revascularization Really Necessary in Patients With ≥50% but <70% Coronary Stenosis Undergoing Valvular Surgery?

Del Forno et al. present a retrospective study of 77 patients with de-novo 50-70% coronary stenosis undergoing valvular surgery. In these patients, bypass grafting of these coronaries was intentionally omitted. Within their cohort they did not observe any perioperative mortality and there was only one acute coronary syndrome leading to PCI and the overall PCI rate at six years was only 8 +/- 3.9%. Therefore, it seems to be safe to not bypass such stenosis and leave it to later follow-up and ischemia diagnostics.