Combined Coronary Revascularization: Single-Center 10-Year Experience

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Cardiac Surgery

Background:

• Coronary revascularization is crucial for managing coronary artery disease.
• Combined approaches may offer advantages but require long-term outcome assessment.

Purpose of the Study:

• To evaluate the long-term outcomes of combined coronary revascularization.
• To assess the safety and efficacy of percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting (CABG).

Main Methods:

• A cohort of 106 patients underwent combined PCI and CABG between 2000 and 2010.
• Procedures were either same-day or staged within 90 days, with PCI always preceding CABG.
• Patients were grouped based on the urgency of PCI (acute coronary syndrome vs. stable disease) or one-stop procedures; off-pump CABG was used in all cases.

Main Results:

• The study involved 107 angioplasties and an average of 1.9 grafts per patient, with 87.7% utilizing arterial grafts.
• No in-hospital deaths occurred; long-term follow-up (mean 6.1 years) showed freedom from ischemic events at 5 years (86.3%) and 8 years (79.7%).
• Freedom from major adverse cardiac or cerebrovascular events was also high at 5 years (88.8%) and 8 years (75.7%), with no significant differences between patient groups.

Conclusions:

• Combined coronary revascularization is associated with increased use of arterial grafts.
• The procedure demonstrates good long-term outcomes regarding ischemic events and major adverse cardiac or cerebrovascular events.
• This approach offers a safe and effective strategy for selected patients with coronary artery disease.