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Intensive care outcome of left main stem disease surgery: A single center three years' experience
Amr S Omar1, Samy Hanoura2, Yasser Shouman2
1Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Unit, Hamad Medical Corporation, Doha 3050, DA, Qatar.
Insights
Coronary artery bypass grafting (CABG) outcomes for patients with left main coronary artery (LMCA) disease are comparable to those without LMCA involvement. However, LMCA disease is linked to a higher prevalence of diabetes.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Interventional Cardiology
Background:
- Significant left main coronary artery (LMCA) disease poses a high mortality risk, necessitating surgical intervention.
- The impact of coronary artery bypass grafting (CABG) on intensive care unit (ICU) morbidity in LMCA disease patients requires further investigation.
Purpose of the Study:
- To assess if LMCA disease is a risk factor for prolonged ICU stay and increased early ICU morbidity.
- To compare ICU outcomes between patients with and without LMCA disease undergoing CABG.
Main Methods:
- A retrospective descriptive study analyzed 399 patients undergoing isolated CABG.
- Patients were categorized into two groups: those with LMCA disease (n=75) and those without (n=324).
- ICU outcomes including length of stay, atrial fibrillation, acute kidney injury, re-exploration, myocardial infarction, and bleeding were correlated.
Main Results:
- Patients with LMCA disease exhibited a higher prevalence of diabetes (43.3% vs 29%, P=0.001).
- No statistically significant differences were observed in ICU length of stay or other morbidity and mortality outcomes between the groups.
Conclusions:
- Post-operative ICU performance in patients with LMCA disease undergoing CABG is comparable to those without LMCA involvement.
- Diabetes is more prevalent in patients with LMCA disease.
- Findings can aid in clinical decision-making and patient care stratification.
Background:
Left main coronary artery (LMCA) supplies more than 80% of the left ventricle, and significant disease of this artery carries a high mortality unless intervened surgically. However, the influence of coronary artery bypass grafting (CABG) surgery on patients with LMCA disease on morbidity intensive care unit (ICU) outcomes needs to be explored. However, the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring.
Aim:
To determine whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome.
Methods:
Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG. Patients were divided into 2 groups; those with LMCA disease as group 1 (75 patients) and those without LMCA disease as group 2 (324 patients). We correlated ICU outcome parameters including ICU length of stay, post-operative atrial fibrillation, acute kidney injury, re-exploration, perioperative myocardial infarction, post-operative bleeding in both groups.
Results:
Patients with LMCA disease had a significantly higher prevalence of diabetes (43.3% vs 29%, P = 0.001). However, we did not find a statistically significant difference with regards to ICU stay, or other morbidity and mortality outcome measures.
Conclusion:
Post-operative performance of Patients with LMCA disease who underwent CABG were comparable to those without LMCA involvement. Diabetes was more prevalent in patients with LMCA disease. These findings may help in guiding decision making for future practice and stratifying the patients' care.
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