Document Detail

Left main coronary artery disease does not affect the outcome of off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  20971248     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left main coronary artery (LMCA) stenosis (≥50%) has historically been recognized as a risk factor among patients undergoing coronary artery bypass grafting. METHODS: From January 2002 to December 2008, a total of 665 patients, 268 of whom had significant LMCA disease, underwent isolated off-pump coronary artery bypass surgery at Shiga Medical University Hospital. We compared the clinical results in the 237 patients with LMCA stenosis (LMCA group) with those in the propensity score-matched 237 patients without LMCA stenosis (non-LMCA group). We performed off-pump surgery in all coronary artery bypass grafting cases with no exclusion criteria. RESULTS: All procedures were performed by off-pump technique without conversion to on-pump. Two patients in the LMCA group (2 of 237; 0.8%) and four in the non-LMCA group (4 of 237; 1.7%) died within 30 days after surgery. Follow-up was completed in 96.2% of the patients. The rates of six-year freedom from all cause death were 87.3% and 60.7% in the LMCA group and non-LMCA group, respectively (p = 0.17), and the corresponding rates for the combined endpoint of cardiac death, myocardial infarction, angina pectoris, repeat coronary intervention, and heart failure were 80.4% and 70.4% (p = 0.98). Multivariate Cox regression analysis revealed chronic renal failure as a statistically significant predictor for late cardiac event. CONCLUSIONS: Off-pump coronary artery bypass grafting is feasible and safe in patients with critical LMCA stenosis and LMCA disease is not recognized as a risk factor after off-pump coronary artery bypass grafting in either the short or the long term.
Tomoaki Suzuki; Tohru Asai; Keiji Matsubayashi; Atsushi Kambara; Norihiko Hiramatsu; Takeshi Kinoshita; Osamu Nishimura
Related Documents :
11003278 - Intraoperative sonographic assessment of graft patency during extracranial-intracranial...
21841188 - Evaluation of pulmonary vein stenosis following pulmonary vein isolation using a novel ...
22131438 - Occlusive concomitant dissections of the carotid and coronary arteries treated with ste...
22169678 - Multivessel beating heart robotic myocardial revascularization increases morbidity and ...
10609908 - Preparation of the internal thoracic artery by vasodilator drugs: is it really necessar...
16227488 - Adrenal vein sampling: how to make it quick, easy, and successful.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1501-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu City, Shiga, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Coronary Artery Bypass, Off-Pump / adverse effects*
Coronary Stenosis / complications*
Kidney Failure, Chronic / etiology
Middle Aged
Proportional Hazards Models
Treatment Outcome
Comment In:
Ann Thorac Surg. 2010 Nov;90(5):1506   [PMID:  20971249 ]

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

Previous Document:  Moderate aortic stenosis in coronary artery bypass grafting patients more than 70 years of age: to r...
Next Document:  Invited commentary.