Very Long-term Outcome of Minimally Invasive Direct Coronary Artery Bypass
| Autor: | Giorgio Mastroiacovo, Sabrina Manganiello, Giulio Pompilio, Carlo Antona, Sergio Pirola, Calogero C. Tedesco, Laura Cavallotti, Francesco Alamanni |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Hybrid coronary revascularization medicine.medical_specialty business.industry medicine.medical_treatment Percutaneous coronary intervention 030204 cardiovascular system & hematology medicine.disease Revascularization Coronary artery disease 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Bypass surgery Median sternotomy Right coronary artery medicine.artery Internal medicine medicine Cardiology Surgery Myocardial infarction Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 111:845-852 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2020.06.025 |
| Popis: | Background Minimally invasive direct coronary artery bypass (MIDCAB) is a well-established, low-impact surgical procedure for revascularization of the left descending coronary artery with the left internal mammary artery. This study aimed to evaluate safety, overall survival, and freedom from major adverse cardiocerebral-related events (MACCE) after 20 years of MIDCAB. Methods This study retrospectively collected a series of 141 patients who underwent MIDCAB between 1997 and 2017, to assess long-term outcome. A total of 133 patients who underwent revascularization of the left descending coronary artery with the left mammary artery through a full median sternotomy were analyzed. Results Actuarial survival rates on a Kaplan-Meier curve were 100%, 95%, 90%, 83%, and 70% at 1, 5, 10, 15, and 20 years, respectively. Freedom from MACCE, defined as myocardial infarction, stroke, and cardiac death, was 97%, 90%, 79%, 75%, and 61% at 1,5,10,15, and 20 years, respectively. At Cox multivariable analysis, age, cancer, and chronic renal insufficiency were found to be independent predictors affecting long-term survival, with a hazard ratio of 1.12 (P = .007), 17.63 (P Conclusions The very long-term clinical outcome of MIDCAB is satisfactory in terms of survival and freedom from MACCE. MIDCAB significantly reduces hospital length of stay and blood transfusions when compared with full sternotomy bypass surgery on the left descending coronary artery and appears to improve prognosis in terms of cardiac-related events and all-cause events effectively. |
| Databáze: | OpenAIRE |
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