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Updated: Dec 31, 2025

Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Significant Left Main Coronary Artery Disease Does Not Incur Any Additional Risk to the Short Term Outcome of Off
P K Biswas1, N C Gomez, S Biswas
1Dr Prodip Kumar Biswas, Registrar, Cardiac Surgery, National Heart Foundation Hospital and Research Institute (NHFH&RI), Mirpur, Dhaka, Bangladesh;
Insights
Off-pump coronary artery bypass grafting surgery is a safe and effective treatment for left main coronary artery disease. Outcomes are comparable to patients without left main disease, demonstrating good clinical results.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Coronary Artery Disease Management
Background:
- Coronary artery disease (CAD) is a leading cause of premature death globally.
- Off-pump coronary artery bypass grafting (OPCABG) has emerged as a widespread surgical technique.
- OPCABG demonstrates favorable outcomes, including in cases of left main coronary artery disease (LMCAD).
Purpose of the Study:
- To evaluate the safety and clinical outcomes of OPCABG in patients with significant LMCAD.
- To compare OPCABG outcomes in LMCAD patients versus those with non-LMCAD requiring surgery.
Main Methods:
- A prospective observational study involving 428 patients undergoing OPCABG.
- Patients were divided into two groups: Group A (significant LMCAD) and Group B (non-LMCAD).
- Risk factors, per-operative, and post-operative outcomes were compared between the two groups.
Main Results:
- Hypertension and dyslipidemia were more prevalent in the LMCAD group.
- Per-operative inotropic support was significantly higher in the LMCAD group (33.6% vs. 24.8%).
- Post-operative outcomes including ventilation time, ICU stay, hospital stay, and complications were similar in both groups.
Conclusions:
- OPCABG is a safe and effective surgical option for significant LMCAD.
- Clinical outcomes following OPCABG for LMCAD are comparable to those without LMCAD.
- The study supports the use of OPCABG in managing complex coronary artery disease involving the left main artery.
Abstract:
Coronary artery disease is the most common form of heart disease and single most important cause of premature death in developed countries. Off pump coronary artery bypass grafting surgery has recently became widespread internationally and has produced good clinical outcome even in left main coronary artery disease following off pump coronary artery bypass grafting surgery. A prospective observational study was conducted in the department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh from January 2015 to September 2016 after fulfillment of enrollment criteria, 428 patients were studied for the purpose of the study and they were grouped in two, significant left main coronary artery disease in group A and non left main coronary artery disease requiring surgery in group B. Comparison of risk factors between groups demonstrates that diabetes mellitus and smoking habit between two groups were almost identical. 69.2% of patient with significant left main coronary artery group were hypertensive and 25.2% were dyslipidaemic in comparison to non left main coronary artery disease group which were 50.9% and 6.5% respectively. Requirement of per operative inotropic support was significantly higher in left main coronary artery group. 33.6% of patient of left main coronary artery group required per operative inotropic support whereas non left main coronary artery group require 24.8%. Postoperative inotropic support, mechanical ventilation time, ICU stay, hospital stay and complication were similar in both these groups. So, we can say that off pump coronary artery bypass grafting surgery for significant left main coronary artery disease is as safe as non left main coronary artery disease.
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