Document Detail


The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting.
MedLine Citation:
PMID:  19154904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Incomplete myocardial revascularization decreases survival for patients undergoing coronary artery bypass grafting. The effects of constructing multiple grafts to each major diseased artery territory are unknown. We aimed to determine the impact on long-term survival after coronary artery bypass grafting of placing multiple grafts to each myocardial territory. METHODS: We reviewed data from 1129 consecutive patients who underwent coronary artery bypass grafting at our institution between 1997 and 2007 and compared outcomes between patients who received multiple grafts to each major diseased artery territory (n = 549) with those of patients who received single grafts to each territory (n = 580). We assessed long-term survival with Kaplan-Meier curves generated by log-rank tests, adjusting for confounding factors with Cox proportional hazards regression analysis. RESULTS: Patients who received multiple grafts to each major diseased artery territory had longer cardiopulmonary bypass and aortic crossclamp times than patients who received single grafts per territory. Patient groups had similar early outcomes, including 30-day mortalities (1.3% vs 1.4%, P > .999) and incidences of major adverse cardiac events (2.9% vs 2.2%, P = .57). Cox regression 10-year survival curves were also similar between groups (adjusted hazard ratio 0.94, 95% confidence interval 0.67-1.34, P = .74). CONCLUSION: Patients who received multiple grafts to each major diseased artery territory had early outcomes similar to those who received single grafts per territory. Constructing multiple grafts to each major diseased artery territory increases operative time and does not improve long-term survival.
Authors:
Danny Chu; Faisal G Bakaeen; Xing Li Wang; Joseph S Coselli; Scott A LeMaire; Joseph Huh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  137     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-02-11     Revised Date:  2009-07-21    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX 77030, USA. dchumd@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass / methods*
Coronary Artery Disease / mortality*,  pathology,  surgery*
Female
Humans
Male
Middle Aged
Survival Rate
Time Factors
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2009 Aug;138(2):513; author reply 513-4   [PMID:  19619811 ]

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


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