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The influence of ascending aortic atherosclerosis on the long-term survival after CABG

Thomas Schachner1, Anne Zimmer, Georg Nagele

  • 1Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck 6020, Austria. thomas.schachner@uibk.ac.at

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|August 30, 2005
PubMed

Insights

Ascending aortic atherosclerosis and other factors like advanced age and carotid artery disease significantly decrease long-term survival after coronary artery bypass grafting (CABG). Identifying these risks improves patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Clinical Outcomes Research

Background:

  • Ascending aortic atherosclerosis is a known risk factor for complications during coronary artery bypass grafting (CABG).
  • Understanding factors influencing long-term survival post-CABG is crucial for patient management.

Purpose of the Study:

  • To evaluate the impact of ascending aortic atherosclerosis on long-term survival after CABG.
  • To identify other significant risk factors affecting long-term outcomes in CABG patients.

Main Methods:

  • Intraoperative epiaortic ultrasound was used to assess ascending aortic wall thickness in 500 CABG patients.
  • Long-term survival follow-up was completed for all included patients, with a median follow-up of 55 months.

Main Results:

  • The 5-year survival rate was 84%; 11% of patients died during follow-up.
  • Factors associated with significantly lower survival included advanced age (≥70 years), COPD, elevated creatinine, reduced LVEF (<40%), ascending aortic wall thickness (≥4mm), carotid artery disease, peripheral vascular disease, and acute operation.
  • Multivariate analysis identified carotid artery disease, LVEF <40%, peripheral vascular disease, and advanced age as independent risk factors.

Conclusions:

  • Ascending aortic atherosclerosis is a significant risk factor for decreased long-term survival post-CABG.
  • Other critical risk factors include elevated creatinine, COPD, carotid artery disease, reduced LVEF, peripheral vascular disease, and advanced age, necessitating careful preoperative assessment and management.
Abstract

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