OBJECTIVES: The aim of the study was to analyse the early and long-term outcomes of a consecutive series of patients who underwent sequential coronary artery bypass grafting (CABG) and to compare them with a matched population of totally arterial revascularized patients. METHODS: From January 1994 to December 1996, 209 patients underwent total arterial myocardial revascularization at our institution [arterial (ART) group]. In the same period, 2097 patients underwent CABG with left internal thoracic artery on left anterior descending and great saphenous vein on the right and circumflex branches sequentially [sequential vein (SV) group]. The propensity score methodology was used to obtain risk-adjusted outcome comparisons between the two groups (209 vs 243 patients in the ART group and SV group, respectively). RESULTS: In-hospital mortality was 1% in the ART group and 0.4% in the SV group (P = 0.86). Mean follow-up was 14 ± 4 years. Long-term survival was comparable among the two study groups [actuarial 5- and 15-year survival rates were 97 vs 93% and 82 vs 79% in the ART group and the SV group, respectively (P = 0.29)]. At follow-up, recurrence of angina (17 vs 18%; P = 0.99), acute myocardial infarction (MI) (3 vs 5%; P = 0.72) and repeated percutaneous coronary intervention (19 vs 21%; P = 0.69) were similar in the ART group compared with the SV group. In the Cox regression analysis, type of revascularization was not an independent predictor of any long-term outcomes (death or major adverse cardiac events). In asymptomatic patients, exercise stress test at follow-up was comparable between the two groups (P = 0.14). CONCLUSIONS: Sequential vein CABG appears to have good early and long-term clinical outcomes. Also, early and long-term incidence of acute MI was not significantly higher in the SV group. However, further studies with a larger population are warranted in order to confirm the present results.
Long-term results of sequential vein coronary artery bypass grafting compared with totally arterial myocardial revascularization : A propensity score-matched follow-up study / A. Garatti, S. Castelvecchio, A. Canziani, L. Corain, T. Generali, E. Mossuto, P. Gagliardotto, L. Anastasia, L. Salmaso, F. Giacomazzi, L. Menicanti. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 46:6(2014), pp. 1006-1013.
|Titolo:||Long-term results of sequential vein coronary artery bypass grafting compared with totally arterial myocardial revascularization : A propensity score-matched follow-up study|
GARATTI, ANDREA (Corresponding)
|Parole Chiave:||CABG, arterial grafts; CABG, venous grafts; Ischaemic heart disease, angina; Outcomes; Angina Pectoris; Blood Vessel Prosthesis; Coronary Artery Bypass; Exercise Test; Female; Follow-Up Studies; Hospital Mortality; Humans; Italy; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Ischemia; Myocardial Revascularization; Propensity Score; Retrospective Studies; Treatment Outcome; Cardiology and Cardiovascular Medicine; Surgery; Pulmonary and Respiratory Medicine; Medicine (all)|
|Settore Scientifico Disciplinare:||Settore BIO/10 - Biochimica|
|Data di pubblicazione:||2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/ejcts/ezu057|
|Appare nelle tipologie:||01 - Articolo su periodico|