Long term survival after coronary endarterectomy in patients undergoing combined coronary and valvular surgery – a fifteen year experience
Open Access
- 26 March 2008
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Cardiothoracic Surgery
- Vol. 3 (1), 15
- https://doi.org/10.1186/1749-8090-3-15
Abstract
Background Coronary Endarterectomy (CE) in patients undergoing coronary artery bypass graft (CABG) surgery has been shown to be beneficial in those with diffuse coronary artery disease. There are no published data on its role and benefit in patients undergoing more complex operations. We present our experience with CE in patients undergoing valve surgery with concomitant CABG. Materials and methods Between 1989 and 2003, 237 patients underwent CABG with valve surgery under a single surgeon at our institution. Of these, 41 patients needed CE. Data was retrospectively obtained from hospital records and database. Further follow-up was obtained by telephone interview. All variables were analyzed by univariate analysis for significant factors relating to hospital mortality. Morbidity and long term survival was also studied. There were 29 males and 12 females with a mean age of 67.4 ± 8.1 and body mass index of 26.3 ± 3.3. Their mean euroscore was 7.6 ± 3.2 and the log euro score was 12.2 ± 16.1. Results Thirty-two patients were discharged from the intensive therapy unit within 48 hours after surgery. Average hospital stay was 12.7 ± 10.43 days. Thirty day mortality was 9.8%. Six late deaths occurred during the 14 year follow up. Ten year survival was 57.2% (95% CL 37.8%–86.6%). Three of the survivors had Class II symptoms, with one requiring nitrates. None required further percutaneous or surgical intervention. We compared the result with the available mortality figure from the SCTS database. Conclusion Compared to the SCTS database for these patients, we have observed that CE does not increase the mortality in combined procedures. By accomplishing revascularization in areas deemed ungraftable, we have shown an added survival benefit in this group of patients.Keywords
This publication has 24 references indexed in Scilit:
- Late outcome of mitral valve surgery for patients with coronary artery diseaseThe Annals of Thoracic Surgery, 2003
- Coronary endarterectomy with off-pump coronary artery bypass surgeryThe Annals of Thoracic Surgery, 2003
- Long-term results of reconstructions of the left anterior descending coronary artery in diffuse atherosclerotic lesionsThe Journal of Thoracic and Cardiovascular Surgery, 1996
- Determinants of early and late results of combined valve operations and coronary artery bypass graftingThe Annals of Thoracic Surgery, 1996
- Adjunctive coronary endarterectomy: Improved safety in modern cardiac surgeryThe Annals of Thoracic Surgery, 1995
- Determinants of survival and recovery of left ventricular function after aortic valve replacementThe Annals of Thoracic Surgery, 1993
- Angioscopic evaluation of intravascular morphology after coronary endarterectomyThe Annals of Thoracic Surgery, 1991
- Coronary artery disease and its management: Influence on survival in patients undergoing aortic valve replacementJournal of the American College of Cardiology, 1987
- Manual Coronary Endarterectomy with Saphenous Bypass: Experience with 263 PatientsThe Annals of Thoracic Surgery, 1981
- SURVIVAL AFTER CORONARY ENDARTERECTOMY IN MANJournal of the American Medical Association, 1957