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Left main coronary artery disease treated with beating heart surgery: 10-year single center results

Tomasz K Urbanowicz1, Michał Michalak2, Anna Olasińska-Wiśniewska1

  • 1Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.

Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology
|July 18, 2024
PubMed

Insights

Off-pump coronary artery bypass grafting (CABG) is a safe option for left main disease, showing similar survival to multivessel disease. Female sex and diabetes mellitus are risk factors for mortality after OPCAB surgery.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Atherosclerosis Research

Background:

  • Left main coronary disease is a severe condition treatable by percutaneous or surgical methods.
  • Off-pump coronary artery bypass grafting (OPCAB) is a surgical option, though its utilization has declined.

Purpose of the Study:

  • To compare 10-year survival rates between patients undergoing OPCAB for left main versus multivessel disease.
  • To identify mortality risk factors in patients undergoing OPCAB surgery.

Main Methods:

  • Retrospective analysis of 159 patients (32% left main, 68% multivessel disease).
  • Utilized regression analysis for long-term mortality risk and Kaplan-Meier survival curves.
  • Transit time bypass measurements were employed post-surgery.

Main Results:

  • No significant difference in 10-year mortality between left main and multivessel disease patients treated with OPCAB (HR = 0.93).
  • Female sex (HR = 1.08) and diabetes mellitus (HR = 6.33) were identified as significant risk factors for 10-year mortality.
  • Surgical intervention was for 51 patients with left main disease and 108 with multivessel disease.

Conclusions:

  • Off-pump surgery for left main disease is a safe and effective technique with favorable long-term outcomes compared to multivessel disease.
  • Female sex and diabetes mellitus are potential risk factors impacting long-term mortality following OPCAB surgery.
Abstract

Keywords:
antiplatelet therapyatrial fibrillationdevice-related thrombusleft atrial appendage closurestroke prevention

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