Surgical Revascularization of Coexistent Significant Left Main and Right Coronary Artery Stenosis: A Single Center
Osama Saber Eldib1, Ahmed Abdelrahman Elassal1, Husain Hamza Jabbad2
1Cardiothoracic Surgery, Zagazig University, Egypt.
Insights
Surgical revascularization for patients with left main and right coronary artery stenosis shows higher complication rates. This study highlights increased morbidity and mortality compared to isolated left main disease treatment.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Cardiac Surgery Outcomes
Background:
- Left main coronary artery stenosis frequently coexists with complex coronary artery disease.
- Surgical revascularization remains the standard treatment for left main coronary artery stenosis.
Purpose of the Study:
- To report surgical revascularization experience in patients with simultaneous left main and right coronary artery stenosis.
- To assess the impact of concomitant right coronary artery disease on surgical outcomes.
Main Methods:
- A cohort of 46 patients (38 male, 8 female, mean age 56.3) underwent coronary artery bypass grafting between 2006 and 2015.
- 93.4% had identified coronary artery disease risk factors; EuroSCORE II was 2.2 ± 4.29.
- All procedures were performed on-pump, averaging 3.3 grafts per patient; 11 patients received intra-aortic balloon pumps.
Main Results:
- Early postoperative mortality was 8.7%.
- Complications included bleeding (6 patients), sternal wound infection (5), renal impairment (5), respiratory issues (2), and myocardial infarction (4).
Conclusions:
- Surgical revascularization for combined left main and right coronary artery stenosis is associated with elevated morbidity and mortality.
- Outcomes are less favorable compared to surgical treatment for isolated left main coronary artery disease.
Background:
Patients with left main coronary artery stenosis often have complex coexisting coronary artery disease. Surgical revascularization is still the standard modality of treatment.
Objective:
To present our experience in surgical revascularization for patients with stenosis of both left main and right coronary artery and evaluate the impact of the latter on the outcome of surgery.
Methods:
From 2006 to 2015, a total of 46 patients (38 male and 8 female, mean age 56.3 years) underwent coronary artery bypass grafts for stenosis of both left main and right coronary artery. Risk factors for coronary artery disease were identified in 93.4%. EuroSCORE II was 2.2 ± 4.29. All were operated on pump with mean grafts 3.3 ± 0.8.1 per patient. Intraaortic balloon was inserted in 11 patients.
Results:
Early postoperative mortality was 8.7%. Regarding complications, we reported bleeding in 6 patients, sternal wound infection in 5, renal impairment in 5, respiratory complications in 2, and myocardial infarction in 4.
Conclusion:
Surgical revascularization for patients with stenosis of both left main and right coronary artery has a higher morbidity and mortality when compared to results of surgery for isolated left main disease.
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