The Influence of Diffuse Left Anterior Descending Artery Lesions on Outcomes of Coronary Artery Bypass Grafting

Authors

  • Yuan-Hsi Tseng Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan
  • Chih-Chen Kao Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan
  • Chien-Chao Lin Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan
  • Ming-Shian Lu Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan
  • Chu-Hsueh Lu Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan
  • Yao-Kuang Huang Division of Thoracic and Cardiovascular Surgery, Chia Yi Chang Gung Memorial Hospital, Chia-Yi and Chang Gung University, College of Medicine, Taoyuan, Taiwan

DOI:

https://doi.org/10.1532/hsf.2975

Keywords:

left anterior descending artery, diffuse coronary disease, coronary artery bypass surgery, coronary artery bypass grafting

Abstract

Background: Diffuse coronary lesions adversely influence the outcomes of coronary artery bypass grafting (CABG). This study aimed to investigate the influence of diffuse left anterior descending artery (LAD) lesions on the outcomes
of CABG.

Methods: The data of 123 patients, who received elective isolated CABG with the left internal mammary artery bypassed to the LAD from January 2011 to June 2017, were collected. According to their lesions (≥50% diameter stenoses) ≤2cm or >2cm in the middle and distal segment of LAD, the patients were classified into a No Diffuse Lesion (NDL) group (69 patients) and a Diffuse Lesion (DL) group (54 patients). The rates of in-hospital mortality, 5-year all-cause mortality, and major cardiac events (MCEs) (i.e. myocardial infarction, angina, acute heart failure, and atrial fibrillation) were analyzed.

Results: According to the univariate analyses, the NDL group had fewer diffuse left circumflex artery (LCX) lesions (P = .001) and higher ventricular fibrillation (Vf) after aortic de-clamping (P = .03) than the DL group. According to the multivariate analyses, the in-hospital and 5-year all-cause mortality rates of the two groups did not significantly differ (P = .80 and P = .59). Otherwise, the DL group had a trend toward more MCEs (hazard ratio = 2.07, P = .061), but the difference clearly was insignificant after adjusting for diffuse LCX lesions and Vf after aortic
de-clamping (P = .104).

Conclusions: The results demonstrated that diffuse LAD lesions did not influence the risks of in-hospital mortality, 5-year all-cause mortality, or MCEs after CABG.

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Published

2020-07-20

How to Cite

Tseng, Y.-H., Chih-Chen Kao, Chien-Chao Lin, Ming-Shian Lu, Chu-Hsueh Lu, & Yao-Kuang Huang. (2020). The Influence of Diffuse Left Anterior Descending Artery Lesions on Outcomes of Coronary Artery Bypass Grafting. The Heart Surgery Forum, 23(4), E498-E506. https://doi.org/10.1532/hsf.2975

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