Abstract
Left main coronary artery disease treated with beating heart surgery: 10-year single center results
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
- Poznan University of Medical Sciences, Poznan, Poland
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
Introduction:
Left main (LM) coronary disease is believed to represent a complex, advanced, and potentially life-threatening atherosclerotic syndrome that can be treated by either percutaneous or surgical interventions. Despite its satisfactory results, the declined number of off-pump coronary artery bypass grafting (OPCAB) is observed.
Aim:
To compare 10-year survival and point out possible mortality risk factors in patients referred for left main and multivessel OPCAB surgery followed by transit time bypass measurements.
Material and methods:
There were 159 patients (128 (81%) men and 31 (19%) women) in a median age of 66 (60–70) years enrolled in retrospective analysis who were referred to surgical intervention due to left main (51, 32%) and multivessel (108, 68%) disease. The regression analysis for long-term mortality risk and the Kaplan-Meyer survival curve were analyzed.
Results:
Multivariable analysis pointed female sex (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) and diabetes mellitus (HR = 6.33, 95% CI: 1.86–21.52, p = 0.003) as possible risk factors for 10-year mortality risk. There was no significant difference in Kaplan-Meyer 10-year mortality comparison between left main and multivessel disease patients treated by off-pump surgical revascularization (HR = 0.93, 95% CI: 0.40–2.13, p = 0.86).
Conclusions:
Off-pump surgery in the left main disease, compared to multivessel disease, represents a safe surgical technique with satisfactory long-term results. The female sex and diabetes mellitus were found as possible risk factors for 10-year mortality risk in multivariable analysis.
Keywords
antiplatelet therapy, atrial fibrillation, stroke prevention, left atrial appendage closure, device-related thrombus
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