ABSTRACT
Primary objective of this study was to evaluate the impact of significant left main stem [LMS] stenosis on the early outcome of coronary artery bypass graft [CABG] surgery. A Retrospective non-randomized analytical study was conducted in Cardiac surgery department, Chaudhary Pervaiz Elahi Institute of Cardiology [CPEIC] Multan, Pakistan. The data of patients who underwent isolated CABG at our institution from February 2008 to March 2014 were analyzed. Two thousand six hundred two [2602] patients of isolated CABG were divided into 2 groups according to the LMS disease. Group I [n=2088]: without significant LMS disease and Group II [n=514]: with LMS disease. Data was analyzed using SPSS V16. The groups were compared using Student's t-test for numeric variables. Chi-square test and Fishers Exact test were used for categorical variables. P-value ? 0.05 was considered as significant difference. Out of two thousand six hundred two, 2088 patients were in Non.LMS group [Control Group] and five hundred fourteen were in LMS Group [Study Group]. Patients with LMS disease were older. In both groups there was no statistically significant difference regarding gender distribution, risk factors of IHD, pre-operative renal function and preoperative CKMB levels. Significant number 50 [9.7%] of patients were unstable in LMS group and they needed urgent surgery [p-value <0.0001]. Need and duration for inotropic support and intra-aortic balloon counter-pulsation support were significantly high in LMS group [p-value <0.0001, 0.002, 0.003 respectively]. Similarly Mechanical ventilation time and hospital stay were higher in LMS group. Incidence of pulmonary complications and operative mortality were significantly higher in LMS group [p-value 0.005 and 0.001 respectively]. Mortality of CABG patients with significant left main coronary stenosis was 13 out of five hundred fourteen [2.5%] as compared to just 17 out of two thousand eighty eight [0.8%] in control group. This study showed that significant LMS disease is an independent risk factor for early cardiopulmonary morbidity and mortality after CABG surgery