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Prognostic value of coronary dominance in patients undergoing elective coronary artery bypass surgery
Selcuk, Emre; Cevirme, Deniz; Bugra, Onursal.
  • Selcuk, Emre; Mus State Hospital. Department of Cardiovascular Surgery. Muş. TR
  • Cevirme, Deniz; Kartal Kosuyolu Research and Education Hospital. Department of Cardiovascular Surgery. Istanbul. TR
  • Bugra, Onursal; Balikesir University. Medical Faculty. Department of Cardiovascular Surgery. Balikesir. TR
Rev. bras. cir. cardiovasc ; 35(4): 452-458, July-Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137293
ABSTRACT
Abstract

Objective:

To evaluate the clinical impact of coronary dominance type in terms of early and long-term outcomes in patients undergoing elective coronary artery bypass grafting (CABG).

Methods:

A total of 844 consecutive patients who underwent elective CABG were divided into two groups based on preoperative angiographic views as left dominant (LD) and right dominant or co-dominant (RD+CD). The measured outcomes were postoperative complications, 30-day mortality, long-term mortality, and major adverse cardiac and cerebrovascular events (MACCE).

Results:

RD+CD was present in 87.9% (n=742) and LD in 12.1% (n=102) of patients. Postoperative complications, 30-day mortality, and 30-day readmissions were similar in both groups. The median duration of follow-up was 3.4 years. LD was not an independent predictor of mortality (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 0.89-2.45, P=0.12), but it was an independent predictor of MACCE in the long term (adjusted HR 2.18, 95% CI 1.39-3.42, P=0.001).

Conclusion:

In patients undergoing elective surgical revascularization, left coronary dominance is associated with increased MACCE risk in the long term. Therefore, the assessment of coronary dominance type should be an integral part of outpatient management after CABG.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Percutaneous Coronary Intervention Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Year: 2020 Type: Article Institution/Affiliation country: Balikesir University/TR / Kartal Kosuyolu Research and Education Hospital/TR / Mus State Hospital/TR

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Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Percutaneous Coronary Intervention Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Year: 2020 Type: Article Institution/Affiliation country: Balikesir University/TR / Kartal Kosuyolu Research and Education Hospital/TR / Mus State Hospital/TR