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Background: There is a paucity of data concerning the clinical characteristics, management, and outcomes of coronary artery bypass graft surgery (CABG) in patients ≤ 45 years old., Aim: We aimed to compare the clinical characteristics, and in-hospital and long-term outcomes of patients ≤ 45 years and > 45 years old, who underwent isolated CABG., Methods: We identified consecutive patients who had isolated CABG in the Department of Cardiac Surgery and Transplantology in the Silesian Centre for Heart Diseases in Zabrze between January 2006 and December 2011 and were enrolled in the Polish National Registry of Cardiac Surgery Procedures (KROK registry). A total of 8196 patients were identified and split into two groups, age ≤ 45 years old (young group; n = 130) and > 45 years old (old group; n = 8066)., Results: Patients ≤ 45 years old were less often females (18.5% vs. 27.6%, p < 0.027), more often smokers (84.6% vs. 66.9%, p < 0.0001), and had a higher incidence of previous myocardial infarction (MI) (40.8% vs. 29.6%, p = 0.008). Patients ≤ 45 years old more often received only one graft (27.7% vs. 15.0%, p < 0.0001), were operated on with minimally invasive direct coronary artery bypass (MIDCAB) technique (12.3% vs. 3.9%, p < 0.0001), and had complete arterial revascularisation (55.4% vs. 18.1%, p < 0.0001). There were no significant differences between the groups regarding in-hospital mortality (0.8% vs. 1.4%, p = 0.808). Long-term outcomes revealed that young patients, compared with the older patients, showed no significant differences in the number of MI (4.6% vs. 5.6%), unstable angina (8.5% vs. 9.9%), coronary angioplasty (12.3% vs. 15.1%), reCABG (0.8% vs. 0.1%), and strokes (2.3% vs. 4.3%) during the follow-up period; long-term mortality occurred less often in the young patients (4.6% vs. 15.0%, p = 0.002)., Conclusions: We conclude that patients ≤ 45 years old requiring CABG differ from their older counterparts in clinical and surgical characteristics. We noted no significant differences in the in-hospital mortality; however, patients ≤ 45 years old had a lower mortality rate in the long-term follow-up.

Background: Coronary artery bypass graft (CABG) surgery is rarely performed in very young patients. The purpose of our study is to compare the characteristics, treatments, in-hospital, and long-term outcomes of two groups of patients less than 40 years of age who had CABG in two successive decades: 1990-2000 and 2001-2011., Methods: We identified 145 consecutive patients who underwent primary isolated CABG. Group 1 consisted of 78 patients operated between 1990-2000 and group 2 consisted of 67 patients operated between 2001-2011. Composite end point assessed at follow-up period involved death or recurrence of symptoms, which we defined as myocardial infarction, a need for percutaneous coronary intervention (PCI), reoperation, or congestive heart failure (CHF).  , Results: Smoking and hypercholesterolemia before CABG were noted as more frequent in group 1 than in group 2: 96.1% versus 83.6%, P = .011; 88.5% versus 61.2%, P = .0001, respectively. Patients from group 2 more frequently received one graft (29.8% versus 11.5%, P = .0059), were operated with off-pump (41.8% versus 0%, P &lt; .0001) or MIDCAB (28.4% versus 0%, P = .0008) techniques, and had complete arterial revascularization (58.2% versus 23.1%, P &lt; .0001). Group 1 patients had a higher prevalence of composite end point (33.9% versus 17.9%, P = .035), with no significant difference in mortality (11.5% versus 10.4%, P = .83)., Conclusion: Patients operated between 1990-2000 had a higher prevalence of smoking and hypercholesterolemia and higher frequency of composite-end point during folow-up period without significant difference in mortality.

We sought to develop a predictive model based exclusively on preoperative factors to identify patients at risk for PrlICULOS following coronary artery bypass grafting (CABG). Retrospective analysis was performed on patients undergoing isolated CABG at a single center between June 1998 and December 2002. PrlICULOS was defined as initial admission to ICU exceeding 72 h. A parsimonious risk-predictive model was constructed on the basis of preoperative factors, with subsequent internal validation. Of 3483 patients undergoing isolated CABG between June 1998 and December 2002, 411 (11.8%) experienced PrlICULOS. Overall in-hospital mortality was higher among these patients (14.4% vs. 1.2%, P

Background: Despite the proposed advantages of off-pump coronary artery bypass graft (CABG) surgery, some controversy remains as to its advantages compared with on-pump CABG. The present study evaluates medium-term outcomes from patients that have been randomized to CABG surgery performed on pump versus off pump., Methods: All consecutive patients enrolled into a previously completed randomized trial comparing CABG surgery performed on (n = 150) versus off (n = 150) pump were included. The analysis was performed on an intention-to-treat basis. The outcomes of interest were all-cause mortality and readmission to hospital for cardiac reason., Results: The in-hospital outcomes were excellent in both groups with a mortality rate of 0.7% in the on-pump versus 1.3% in the off-pump group (P = .56). Median follow-up was 3.8 years (interquartile range, 3.4-4.4 years) with 1 patient lost to follow-up (99% complete). There were 12 late deaths, 8 in the off-pump group and 4 in the on-pump group, which were not statistically different between groups (P = .23) and resulted in a greater than 90% survival at 4 years. Freedom from readmission to hospital for cardiac cause was not statistical different between the 2 groups with 70% event-free survival at 4 years. Multivariate analysis failed to identify the type of procedure (on vs off pump) as an independent predictor of adverse cardiovascular event (mortality + readmission to hospital)., Conclusions: We have shown that in patients randomized to CABG surgery performed on pump versus off pump, excellent medium-term results can be obtained with either technique. We have been unable to demonstrate that one technique is superior to the other.