| Left main coronary artery disease does not affect the outcome of off-pump coronary artery bypass grafting. | |
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MedLine Citation:
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PMID: 20971248 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Tomoaki Suzuki; Tohru Asai; Keiji Matsubayashi; Atsushi Kambara; Norihiko Hiramatsu; Takeshi Kinoshita; Osamu Nishimura |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-25 Completed Date: 2010-11-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1501-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu City, Shiga, Japan. suzukit@belle.shiga-med.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Bypass, Off-Pump / adverse effects* Coronary Stenosis / complications* Female Humans Kidney Failure, Chronic / etiology Male Middle Aged Proportional Hazards Models Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2010 Nov;90(5):1506
[PMID:
20971249
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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