scholarly journals Coronary Artery Bypass Graft for Left Main Coronary Artery Disease

2015 ◽  
Vol 22 (2) ◽  
pp. 25-29
Author(s):  
Husain H. Jabbad

Because left main coronary artery disease carries a high risk of morbidity and mortality, this retrospective study will review the data and results of surgical management of left main coronary artery disease, in King Abdulaziz University Hospital. 448 patients underwent coronary bypass graft into two groups, left main group (50) patients and non-left main group (398) patients. Preoperative data, risk factors and cardiac catheterization findings were compared in between the two groups in addition to perioperative morbidity and mortality. Patients in the left main group were younger in age with significantly lower ejection fraction and more risk factors (hypertension, dyslipidemia, and smoking). In our study the left main group patients had higher mortality than non-left main patients [4 patients = 8%, 6 patients = 1.8%]; the most common cause of perioperative mortality in the left main group was low cardiac output state, and the most common complications were perioperative myocardial infarction and prolonged ventilation. The higher mortality and morbidity associated with surgery for left main coronary artery disease can be explained by the higher risk profi le, the need of urgent surgery and critical preoperative status.  

2015 ◽  
Vol 22 (2) ◽  
pp. 25-29
Author(s):  
Husain H. Jabbad

Because left main coronary artery disease carries a high risk of morbidity and mortality, this retrospective study will review the data and results of surgical management of left main coronary artery disease, in King Abdulaziz University Hospital. 448 patients underwent coronary bypass graft into two groups, left main group (50) patients and non-left main group (398) patients. Preoperative data, risk factors and cardiac catheterization findings were compared in between the two groups in addition to perioperative morbidity and mortality. Patients in the left main group were younger in age with significantly lower ejection fraction and more risk factors (hypertension, dyslipidemia, and smoking). In our study the left main group patients had higher mortality than non-left main patients [4 patients = 8%, 6 patients = 1.8%]; the most common cause of perioperative mortality in the left main group was low cardiac output state, and the most common complications were perioperative myocardial infarction and prolonged ventilation. The higher mortality and morbidity associated with surgery for left main coronary artery disease can be explained by the higher risk profi le, the need of urgent surgery and critical preoperative status.  


2013 ◽  
Vol 6 ◽  
pp. CCRep.S11542
Author(s):  
Antoine Kossaify ◽  
Gilles Grollier

We report on an octogenarian patient presenting with an acute coronary syndrome due to significant left main coronary artery disease and severe ostial stenosis of the left anterior descending artery disease. Emergent bypass graft performed with “beating heart” consisted of left internal mammary graft to the mid left anterior descending artery with an “over-stent” anastomosis. The immediate post-operative phase was simple, however the patient presented on post-operative day 8 with extensive anterior myocardial infarction and cardiogenic shock. Emergent coronary angiogram showed subocclusive anastomotic stenosis. Percutaneous coronary intervention was performed on left main, proximal left anterior descending, and proximal circumflex arteries. Subsequently, the patient restored a satisfactory hemodynamic condition. A focus on the importance of decision for management of left main disease especially in octogenarian is presented, along with a review of the pertinent literature.


2006 ◽  
Vol 152 (4) ◽  
pp. 693.e7-693.e12 ◽  
Author(s):  
Sang-Wook Kim ◽  
Gary S. Mintz ◽  
Esteban Escolar ◽  
Patrick Ohlmann ◽  
Jerzy Pregowski ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Waqas Ullah ◽  
Yasar Sattar ◽  
Irfan Ullah ◽  
Ammu Susheela ◽  
Maryam Mukhtar ◽  
...  

Background. The safety and efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for stable left main coronary artery disease (LMCAD) remains controversial. Methods. Digital databases were searched to compare the major adverse cardiovascular and cerebrovascular events (MACCE) and its components. A random effect model was used to compute an unadjusted odds ratio (OR). Results. A total of 43 studies (37 observational and 6 RCTs) consisting of 29,187 patients (PCI 13,709 and CABG 15,478) were identified. The 30-day rate of MACCE (OR, 0.56; 95% CI, 0.42–0.76; p = 0.0002) and all-cause mortality (OR, 0.52; 95% CI, 0.30–0.91; p = 0.02) was significantly lower in the PCI group. There was no significant difference in the rate of myocardial infarction (MI) (p = 0.17) and revascularization (p = 0.12). At 5 years, CABG was favored due to a significantly lower rate of MACCE (OR, 1.67; 95% CI, 1.18–2.36; p = <0.04), MI (OR, 1.67; 95% CI, 1.35–2.06; p = <0.00001), and revascularization (OR, 2.80; 95% CI, 2.18–3.60; p = <0.00001), respectively. PCI was associated with a lower overall rate of a stroke, while the risk of all-cause mortality was not significantly different between the two groups at 1- (p = 0.75), 5- (p = 0.72), and 10-years (p = 0.20). The Kaplan–Meier curve reconstruction revealed substantial variations over time; the 5-year incidence of MACCE was 38% with CABG, significantly lower than 45% with PCI (p = <0.00001). Conclusion. PCI might offer early safety advantages, while CABG provides greater durability in terms of lower long-term risk of ischemic events. There appears to be an equivalent risk for all-cause mortality.


1980 ◽  
Vol 303 (17) ◽  
pp. 953-957 ◽  
Author(s):  
Bernard R. Chaitman ◽  
Willliam J. Rogers ◽  
Kathryn Davis ◽  
Denis H. Tyras ◽  
Robert Berger ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document