Left Main Coronary Artery Disease and Outcome of OPCABG
DOI:
https://doi.org/10.3329/cardio.v17i1.80248Keywords:
IHD, Left main disease, CABG, BangladeshAbstract
Background: Because of concern about the ability to tolerate beating heart grafting, patients with left main coronary artery stenosis (≥50%) have been excluded from off-pump bypass. The objective of the present study was to evaluate the safety and efficacy of off- pump coronary artery surgery in patients with left main coronary artery disease.
Methods: From March 2020 to December 2021, a total of 437 patients, 159 of whom had significant LMCA disease, underwent isolated OPCAB surgery under a single Cardiac surgeon at Khulna City Medical College Hospital. We compared the clinical outcomes of 100 patients with LMCA stenosis (LMCA group) with those of 100 propensity score-matched patients without LMCA stenosis (non-LMCA group). We performed off-pump technique in all coronary artery bypass grafting cases. Patients were followed up for any major adverse cardiovascular events up to three years.
Results: All CABG were performed by off-pump technique without conversion to on-pump. One patients in the LMCA group (1 of 100; 1%) and one in the non-LMCA group (1 of 100; 1%) died within 30 days after surgery. Follow-up was completed in 98% of the patients. The rates of three-year freedom from all cause death were 97.3% and 77.7% in the LMCA group and non- LMCA group, respectively (p = 0.17), and the corresponding rates for the combined endpoint of myocardial infarction, angina pectoris, repeat coronary intervention, and heart failure were 80.4% and 70.4% (p = 0.98).
Conclusions: Off-pump coronary artery bypass grafting is feasible and safe in patients with critical LMCA stenosis and LMCA disease is not recognized as a risk factor after off-pump coronary artery bypass grafting in either the short or the Mid-term.
Cardiovasc j 2024; 17(1): 24-30
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