| Ostial left main coronary artery stenosis as an additional risk factor in off-pump coronary artery bypass grafting. | |
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MedLine Citation:
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PMID: 21679974 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Our aim was to determine whether general left main coronary artery stenosis (LMS) and ostial LMS pose additional risks after off-pump coronary artery bypass grafting (CABG) relative to non-left main coronary artery stenosis. METHODS: From January 1, 2008, to December 31, 2009, 4366 patients underwent primary isolated off-pump CABG at Beijing Anzhen Hospital. Disease was retrospectively classified as non-left main disease (n = 3523), nonostial LMS (n = 765), and ostial LMS (n = 78). Groups were propensity score matched. Kaplan-Meier freedoms from major adverse cardiac and cerebrovascular events (MACCEs) were calculated. RESULTS: During the first 30 postoperative days, mortality was significantly higher in the ostial LMS group (6.41%) than in non-left main disease (0.855%, χ(2) = 7.78, P = .005) and nonostial LMS (1.28%, χ(2) = 4.71, P = .03) groups. Incidence of MACCEs was significantly higher in the ostial LMS group (20.5%) than in non-left main disease (5.98%, P = .000) and nonostial LMS (9.62%, P = .002) groups. Odds ratio for early MACCEs of ostial LMS versus non-left main disease was 3.74 (95% confidence interval, 1.72-8.17). At mean follow-up 12.8 ± 7.5 months and cumulative follow-up 498.5 patient-years, difference among groups in freedom from MACCEs did not reach statistical significance (χ(2) = 2.39, P = .303). CONCLUSIONS: Ostial LMS poses additional early risks of mortality and MACCEs in off-pump CABG. Off-pump CABG for ostial LMS should proceed with greater of intraoperative surveillance and lower threshold for converting to on-pump CABG. |
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Authors:
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Hui-Li Gan; Jian-Qun Zhang; Wei Xiao; Shuang Zhao; Fang-Jong Huang; Cheng-Xiong Gu; Chun-Shang Lu; Pi-Shan Wang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-14 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: - ISSN: 1097-685X ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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