Left main coronary disease: improved early outcomes after off-pump coronary artery bypass grafting in high-risk patients

Left main coronary disease: improved early outcomes after off-pump coronary artery bypass grafting in high-risk patients

Left main coronary artery (LMCA) stenosis is a risk factor in coronary artery bypass grafting (CABG). Although improved outcomes of off-pump CABG have been well documented, LMCA stenosis is often perceived as a contraindicationfor off-pump CABG. In this study, we compared on-pump and off-pump techni...

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Bibliographic Details
Published in:Kardiologia polska Vol. 71; no. 8; pp. 796 - 802
Main Authors: Kiziltepe, Ugursay, Kurtoglu, Murat, Ozerdem, Gokhan, Sahinalp, Sahin, Temizturk, Zeki, Bozguney, Muhammed
Format: Journal Article
Language:English
Published: Poland 01-01-2013
Subjects:
Aged
Blood Transfusion - utilization
Cohort Studies
Coronary Artery Bypass, Off-Pump - mortality
Coronary Disease - mortality
Coronary Disease - surgery
Female
Hospital Mortality
Humans
Length of Stay
Male
Retrospective Studies
Survival Rate
Treatment Outcome
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Summary:Left main coronary artery (LMCA) stenosis is a risk factor in coronary artery bypass grafting (CABG). Although improved outcomes of off-pump CABG have been well documented, LMCA stenosis is often perceived as a contraindicationfor off-pump CABG. In this study, we compared on-pump and off-pump techniques in high-risk patients with LMCA disease. Documentation of safety and feasibility of off-pump CABG in patients with LMCA disease. One hundred ninty nine patients with LMCA disease and a EuroScore ≥ 5 were operated upon between 2007 and 2010. One hundred patients (Group I) were operated upon using off-pump techniques, while 99 (Group II) were operated upon using conventional on-pump techniques. Perioperative variables and outcomes at first six months were compared. Despite higher mean age and EuroScore (70.9 ± 4.8 vs. 65.6 ± 7.9, p < 0.001, and 6.09 ± 0.8 vs. 5.31 ± 0.68,p < 0.001, respectively), and lower ejection fraction (41.4 ± 7.3 vs. 49.0 ± 6.2, p < 0.001), hospital mortality (1% vs. 6.1%,p = 0.065), postoperative inotropic support (9% vs. 48.4%, p < 0.001), blood loss (680.6 ± 265.0 vs. 847.2 ± 382, p < 0.001) and transfusions of blood (0.57 ± 0.79 U vs. 1.49 ± 0.82 U, p < 0.001), and hospital stay (6.57 ± 2.04 vs. 7.68 ± 3.44,p = 0.006) were lower in Group I. In both groups, mean number of distal anastomoses and completeness of revascularisation were similar. Using the off-pump technique is safe and improves postoperative early outcomes in high-risk patients with LMCA disease.
ISSN:0022-9032
1897-4279
DOI:10.5603/KP.2013.0190