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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Peripheral vascular disease and outcomes following coronary artery bypass graft surgery

Ted Collison1, J Michael Smith, Amy M Engel

  • 1Department of Surgery, Good Samaritan Hospital, 375 Dixmyth Avenue, Cincinnati, OH 45220, USA.

Archives of Surgery (Chicago, Ill. : 1960)
|December 21, 2006
PubMed

Insights

Patients with peripheral vascular disease (PVD) undergoing coronary artery bypass grafting (CABG) face higher risks and more complications. This study highlights increased rates of arrhythmias, neurological, and pulmonary issues in PVD patients post-CABG.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Peripheral vascular disease (PVD) is associated with increased operative risk in patients undergoing coronary artery bypass grafting (CABG).
  • Outcome differences exist between CABG patients with and without a history of PVD.

Purpose of the Study:

  • To investigate the operative risks and outcome differences in CABG patients with a history of PVD.
  • To identify specific complications and risk factors associated with PVD in the context of CABG.

Main Methods:

  • A 10-year prospective hospitalization cohort study.
  • Comparison of 1561 CABG patients with PVD against 6328 CABG patients without PVD.
  • Analysis of 42 potential confounding risk factors and 16 outcome variables using logistic regression.

Main Results:

  • CABG patients with PVD exhibited significantly higher rates of treated arrhythmias (OR, 1.7), neurological complications (OR, 1.7), pulmonary complications (OR, 1.4), low output (OR, 1.3), and intraoperative complications (OR, 1.39).
  • Twenty-nine potential risk factors were significantly different between the two groups.
  • Logistic regression confirmed these increased complication rates even after controlling for confounding factors.

Conclusions:

  • Patients with a history of PVD undergoing CABG have more coexistent risk factors.
  • These patients experience significantly higher rates of cardiac, systemic, renal, neurologic, and pulmonary complications following CABG.
  • PVD is an independent predictor of adverse outcomes in CABG surgery.
Abstract

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