Early and late survival after surgical revascularisation for left main coronary artery stenosis in stent era

Br J Cardiol 2012;19:134–8doi:10.5837/bjc.2012.025 Leave a comment
Click any image to enlarge
Authors:

We report the early and late results of coronary artery bypass graft (CABG) for protected and unprotected left main coronary artery (LMS) stenosis in an era of growing interest in LMS stenting.

We identified 1,707 patients who had CABG for LMS stenosis between February 1996 and December 2009, and compared their clinical characteristics and outcomes with a contemporaneous group of 6,260 people with non-LMS disease. A subgroup analysis of protected versus unprotected LMS cohorts was also performed. Follow-up data were 99.9% complete.

The LMS group, often male (82% vs. 79%, p=0.01) and older (mean 65.3 ± 9 vs. 63.6 ± 9 years, p<0.0001), frequently had ejection fraction <0.50 (25.2% vs. 23.9%, p=0.002) and urgent/emergency surgery (40% vs. 24%, p<0.0001). Overall, operative mortality was higher for the LMS group (2.7% vs. 1.1%, p<0.0001), and there was improvement over time (2.3% vs. 0.8% in the later period). There was no difference between protected and unprotected LMS cohorts (operative mortality 2.2 vs. 2.8, p=0.54).

The respective 10-year survival rates for LMS and non-LMS patients were 75% and 79% (p=0.001). By multi-variate analysis, LMS stenosis was a predictor of operative mortality (odds ratio 2.05, 95% confidence interval 1.29–3.25, p=0.002) but not a determinant for late death. 

In conclusion, CABG yields good early and late survival benefit for LMS stenosis (protected and unprotected), although operative result is adversely affected by LMS disease. 

Pay to access this premium content £5

The BJC is introducing a small charge for some of its premium content. On purchase you will receive an email to access the article and have a downloadable PDF to keep. The PDF can be downloaded from a button on the sidebar. Please note the purchase of this article is for your personal use only.
By supporting us in this way, you are helping us to deliver high-quality services to healthcare professionals. We will continue to keep the majority of our content free of charge.


You can access this article without logging in.
But don't miss out on the many Benefits of our Membership. Register Now.
Already a member? Login Now.
THERE ARE CURRENTLY NO COMMENTS FOR THIS ARTICLE - LEAVE A COMMENT