Open AccessLong-term outcomes of reconstructive procedures on coronary arteries for diffuse coronary atherosclerosis without endarterectomy
Author(s) -
С. А. Белаш,
S. I. Shevchenko,
Е. П. Ясакова,
К. О. Барбухатти,
В. А. Порханов
Publication year - 2020
Publication title -
innovacionnaâ medicina kubani
Language(s) - English
Resource type - Journals
eISSN - 2541-9897
pISSN - 2500-0268
DOI - 10.35401/2500-0268-2020-20-4-6-13
Subject(s) - medicine , cardiology , coronary artery disease , angina , artery , endarterectomy , coronary atherosclerosis , surgery , coronary arteries , myocardial infarction , stenosis
Objective . This study evaluated the long-term clinical and angiographic outcomes of coronary artery reconstruction for a diffusely diseased coronary artery without endarterectomy. Material and Methods . We retrospectively reviewed 660 consecutive patients (mostly men (89.5%), mean age 68.3 ± 7.4 years) who underwent coronary artery bypass grafting in combination with coronary artery reconstruction between 2003 and 2016. 558 operated on patients (84.5%) were followed up for a mean of 94.3 ± 31.2 months. Results . Long-term survival was 83.2% (95% confidence interval: 74.5–89.3); freedom from cardiac death was 97.4 ± 1.2%; and freedom from major adverse cardiac and cerebrovascular events was 64.7 ± 4.1%. Independent predictors of long-term mortality were age at surgery (< 70 years, p < 0.001), chronic obstructive pulmonary disease (p = 0.007), peripheral arterial disease (p = 0.002), diabetes mellitus (p = 0.013) and chronic kidney disease (p = 0.034). The arterial graft patency rate was 95.2%, and the vein graft patency rate was 75.4%. Conclusion . Coronary artery bypass grafting in conjunction with coronary artery reconstruction without endarterectomy confers satisfactory long-term clinical outcomes with high probability of freedom from cardiac death and angina pectoris, good rates of angiographic patency of arterial grafts and favorable rates of vein graft patency.