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High volume practice proved the safety of off-pump coronary artery bypass surgery in left main coronary artery lesions: a two-year single center experience / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 3861-3867, 2012.
Article in English | WPRIM | ID: wpr-256627
ABSTRACT
<p><b>BACKGROUND</b>Left main coronary artery (LMCA) stenosis has been recognized as a risk factor for early death among patients undergoing coronary artery bypass grafting (CABG). This study aimed to assess if LMCA lesions pose an additional risk of early or mid-term mortality and/or a major adverse cardiac and cerebrovascular event (MACCE) after off-pump coronary artery bypass grafting (OPCABG), compared with non-left main coronary artery stenosis (non-mainstem disease).</p><p><b>METHODS</b>From January 1, 2009 to December 31, 2010, 4869 patients had a primary isolated OPCABG procedure at Beijing Anzhen Hospital. According to the pathology of LMCA lesions, they were retrospectively classified as a non-mainstem disease group (n = 3933) or a LMCA group (n = 936). Propensity scores were used to match the two groups, patients from the non-mainstem disease group (n = 831) were also randomly selected to match patients from the LMCA group (n = 831). Freedom from MACCE in the two groups was calculated using the Kaplan-Meier method.</p><p><b>RESULTS</b>The difference in the mortality and the rate of MACCE during the first 30 days between the non-mainstem disease group and the LMCA group did not reach statistical significance (P = 0.429, P = 0.127 respectively). With a mean follow-up of (12.8 ± 7.5) months and a cumulative follow-up of 1769.6 patient-years, the difference in the freedom from MACCEs between the two groups, calculated through Kaplan-Meier method, did not reach statistical significance (P = 0.831).</p><p><b>CONCLUSION</b>Analysis of a high volume of OPCABG procedures proved that LMCA lesions do not pose additional early and mid-term risk to OPCABG. Therefore, a LMCA lesion is as safe as non-mainstem disease lesion during the OPCABG procedure.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Coronary Artery Disease / Retrospective Studies / Follow-Up Studies / Mortality / Coronary Artery Bypass, Off-Pump / Kaplan-Meier Estimate Type of study: Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2012 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Coronary Artery Disease / Retrospective Studies / Follow-Up Studies / Mortality / Coronary Artery Bypass, Off-Pump / Kaplan-Meier Estimate Type of study: Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2012 Type: Article