Short and long-term results of endoscopic atraumatic coronary artery off-pump bypass grafting in patients with left anterior descending artery stenosis.

Autor:	Abusamra R; Al Zahra Hospital Sharjah, United Arab Emirates.; Medical University of Silesia, Katowice, Poland., Król M; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Milewski K; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland.; The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland., Kachel M; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland. mtkachel@gmail.com., Abudaqa L; Al Qassimi Hospital, Sharjah, UAE., Jankowska-Sanetra J; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Derbisz K; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Sanetra K; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Sobieszek A; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Buszman PP; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Wojakowski W; Medical University of Silesia, Katowice, Poland., Buszman PE; Medical University of Silesia, Katowice, Poland.; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland., Bochenek A; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland.; Medical University of Silesia, Katowice, Poland., Cisowski M; Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland.; Medical University of Silesia, Katowice, Poland.
Jazyk:	angličtina
Zdroj:	Cardiology journal [Cardiol J] 2021; Vol. 28 (1), pp. 86-94. Date of Electronic Publication: 2019 Jan 31.
DOI:	10.5603/CJ.a2019.0006
Abstrakt:	Background: To perform a retrospective analysis of patients who underwent endoscopic atraumatic coronary artery off-pump bypass grafting (EACAB) in a single center over a period of 11 years. Methods: Data was acquired from the hospital registry and patient medical records. In order to determine changes in clinical profile, patients were subdivided into three groups regarding year of surgery: 1998-2002 (group 1), 2003-2005 (group 2), 2006-2009 (group 3). In-hospital analysis up to 30 days and long-term observation were conducted. Results: The study cohort consisted of 714 patients (581 male). Procedural success accounted for 99% of all patients. No mortality was observed up to 30 days. Complications in the early period included pleural effusion (7.6%), cardiac arrhythmias (3.6%), bleeding related revision (2.7%) and wound infection (1.6%). Mean follow-up was 6 years (2132 ± 1313 days; median: 1918.5). Nineteen (2.7%) patients died, of which 52.6% (10 patients) were due to heart related conditions. Overall frequency of major adverse cerebral and cardiovascular events (MACCE) was 10.8% (77 patients). The Kaplan-Meyer analysis defined survival rate and event-free survival in long-term observation of 96.1% and 85.3%, respectively. Ejection fraction (EF) < 50% was the only independent factor of mortality (OR: 3.35). Regarding cumulative MACCE, older age (OR: 1.72), lower EF (OR: 3.03), the history of percutaneous coronary intervention (OR: 2.13) and higher New York Heart Association class (OR: 2.63) influenced the incidence rate. Conclusions: The presented short and very long-term results confirm that EACAB is an efficient alternative for patients requiring revascularization of the left anterior descending artery. The elimination of cardiopulmonary bypass significantly reduces the number of complications.
Databáze:	MEDLINE
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