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Mid-term outcomes of coronary endarterectomy combined with coronary artery bypass grafting
- Source :
- Interact Cardiovasc Thorac Surg
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- OBJECTIVES The aim of this study was to evaluate the mid-term outcome of coronary endarterectomy (CE) combined with coronary artery bypass grafting (CABG) and explore the potential risk factors for adverse events. METHODS A total of 208 consecutive patients underwent CE between 2008 and 2018 in our centre, of which 198 were included in this retrospective cohort study. The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs). Kaplan–Meier analysis was performed to evaluate event-free survival, whereas subgroup analysis and Cox regression were used to explore risk factors for the outcomes. RESULTS The median follow-up time was 34.7 months. CE + CABG was performed mainly on the left anterior descending artery (42.3%) or right coronary artery (42.3%). Both operative mortality and incidence of perioperative myocardial infarction were 1.5%. The overall survival at 3 and 5 years was 98.0% and 95.9%, whereas the MACCE-free survival was 93.7% and 89.4%, respectively. No significant difference in the incidence of MACCE was observed between on-pump and off-pump CE (P = 0.256) or between left anterior descending artery and non-left anterior descending artery endarterectomy (P = 0.540). Advanced age (>65 years) was associated with a higher risk of MACCE both in univariate [hazard ratio (HR) 3.62, 95% confidence interval (CI) 1.37–9.62; P = 0.010] and multivariate analysis (HR 3.59, 95% CI 1.32–9.77; P = 0.013). CONCLUSIONS When performed by experienced surgeons, CE + CABG could be an acceptable approach to achieve complete revascularization of diffusely diseased coronary arteries with satisfactory outcomes, although advanced age might increase the risk of MACCE.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
Coronary Artery Disease
Endarterectomy
Revascularization
Cohort Studies
Coronary artery bypass surgery
Risk Factors
Internal medicine
medicine.artery
medicine
Humans
Myocardial infarction
Coronary Artery Bypass
Aged
Retrospective Studies
Adult Cardiac
business.industry
Hazard ratio
Retrospective cohort study
Middle Aged
medicine.disease
Coronary Vessels
Coronary arteries
Treatment Outcome
medicine.anatomical_structure
Right coronary artery
Cardiology
Surgery
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15699285
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Interactive CardioVascular and Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....8af2b87d63019a30272937be6b4134b8