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.
- Author:
Tong LIU
1
;
Jia-Kai LU
;
Hui-Li GAN
;
Jian-Qun ZHANG
;
Fang-Jong HUANG
;
Cheng-Xiong GU
;
Qing-Yu KONG
;
Xiang-Rong CAO
;
Ping BO
;
Chun-Shan LU
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Coronary Artery Bypass, Off-Pump; adverse effects; mortality; statistics & numerical data; Coronary Artery Disease; surgery; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Retrospective Studies
- From: Chinese Medical Journal 2012;125(21):3861-3867
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDLeft 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).
METHODSFrom 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.
RESULTSThe 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).
CONCLUSIONAnalysis 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.