Document Detail


Impact of incomplete revascularization following OPCAB surgery.
MedLine Citation:
PMID:  19732224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The aim of this study was to evaluate the early and mid-term off-pump coronary artery bypass surgery (OPCAB) results in a single surgical unit, assessing the impact of completeness of revascularization. METHODS: Three hundred and twelve patients underwent OPCAB between August 2000 and January 2005. In-hospital data were collected prospectively for all patients undergoing OPCAB. Complete revascularization (CR) was derived by comparing significantly stenotic vessels at cardiac catheterization with surgically grafted coronary vessels. Grafting of all the significantly stenotic coronary vessels was considered CR. In-hospital outcomes were compared between patients with CR and incomplete revascularization (IR). A multivariate analysis based on the Cox proportional hazards regression model was performed. RESULTS: Patients receiving IR (105 patients, 43.7%) presented a worse preoperative risk profile then those having CR (mean Euroscore 6.8 +/- 2.9 vs. 4.3 +/- 2.8, p < 0.0001). IR was not associated with a higher incidence of early adverse events. Five-year freedom from death and major adverse cardiac events (MACE) were 0.88 (0.02 SE) and 0.86 (0.03 SE), respectively. Complete revascularization was protective for mid-term unstable angina recurrence [heart rate (HR) = 0.24, 95% confidence interval (CI) 0.10 to 0.58], acute myocardial infarction (HR = 0.25, 95% CI 0.09 to 0.73), all-cause repeat revascularization (HR = 0.35, 95% CI 0.13 to 0.90), and MACE (HR = 0.2, 95% CI 0.1 to 0.5). CONCLUSION: Our study suggests that, although incomplete revascularization may not result in increased short-term morbidity and mortality, it increases the incidence of mid-term MACE.
Authors:
Marco Agostini; Carlo Fino; Pierfederico Torchio; Antonello Vado; Marco Bertora; Elisa Lugli; Claudio Grossi
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Publication Detail:
Type:  Journal Article     Date:  2009-09-02
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  24     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2010-01-18     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  650-6     Citation Subset:  IM    
Affiliation:
Cardiovascular Department, S. Croce e Carle Hospital, Cuneo, Italy. agostini.m@ospedale.cuneo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina, Unstable / diagnosis,  mortality,  surgery
Coronary Artery Bypass, Off-Pump*
Coronary Stenosis / diagnosis*,  mortality,  surgery*
Disease-Free Survival
Female
Follow-Up Studies
Hospital Mortality
Humans
Italy
Male
Middle Aged
Multivariate Analysis
Postoperative Complications / diagnosis*,  mortality
Proportional Hazards Models
Recurrence
Reoperation
Risk Assessment
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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