Short and long-term results of endoscopic atraumatic coronary artery off-pump bypass grafting in patients with left anterior descending artery stenosis
| Autor: | Mateusz Kachel, Krzysztof Sanetra, Justyna Jankowska-Sanetra, Kamil Derbisz, Paweł Buszman, Piotr P. Buszman, Rafik Abusamra, Andrzej Bochenek, Krzysztof Milewski, Loai Abudaqa, Anna Sobieszek, Marek Król, Marek Cisowski, Wojciech Wojakowski |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Canada Pleural effusion medicine.medical_treatment Constriction Pathologic Coronary Artery Disease Revascularization Single Center law.invention Percutaneous Coronary Intervention law Internal medicine medicine Cardiopulmonary bypass Humans Survival rate Retrospective Studies Ejection fraction business.industry Percutaneous coronary intervention General Medicine Middle Aged medicine.disease Coronary Vessels Stenosis Treatment Outcome Cardiology Original Article Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Cardiol J |
| Popis: | 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: | OpenAIRE |
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