Document Type : Original Article(s)
Authors
- Mohammad Hosein Soltani 1
- Majid Rasti 2
- Seyedeh Mahdieh Namayandeh 3
- Mohammadtaghi Sarebanhassanabadi 3
1 Assistant Professor, Fellowship in Heart Failure, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Cardiologist, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Assistant Professor, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract
BACKGROUND: Coronary artery disease (CAD) is a major problem in Iran as well as throughout the globe, and coronary artery bypass grafting (CABG) surgery is an appropriate option for many patients with symptomatic and severe CAD. The main purpose of this study was assessment of the short and long-term outcomes of patients undergoing CABG in Yazd Province, Iran.METHODS: This historical cohort study examined the mortality rates of patients who had undergone CABG in Afshar Hospital in Yazd from 2011 to 2013. During this period, 2510 patients undergoing CABG were entered into the study and then followed for in-hospital and long-term mortality.RESULTS: Mean age of the patients was 61.37 ± 10.50 years and 34.1% were women. In-hospital mortality turned out to be 3.7% and age over 70, left ventricular (LV) dysfunction, female gender, and left main (LM) involvement induced significant higher in-hospital mortality. Of all the patients, 84.1% were followed for a period of 41 ± 20 months. The survival rate proved to be 92.4% in one year and 82.9% in five years. The patients with age over 70, diabetes mellitus (DM), and LV systolic dysfunction (LVSD) showed significant lower survival rate, whereas the patients with utilization of left internal mammary artery (LIMA) demonstrated significant higher survival rate.CONCLUSION: In-hospital and long-term mortality rate of patients undergoing CABG surgery is acceptable in comparison with other studies and more effort is needed into making this event a success.
Keywords
- Word Health Organization. Prevention and Control of Noncomminucable Disease: Implementation of the Global Strategy. Report by the Secretariat [Online]. [cited 2008]; Available from: https://apps.who.int/iris/handle/10665/23180
- Hawkes AL, Nowak M, Bidstrup B, Speare R. Outcomes of coronary artery bypass graft surgery. Vasc Health Risk Manag 2006; 2(4): 477-84.
- Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 124(23): e652-e735.
- Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal 2019; 40(2): 87-165.
- Alexander JH, Smith PK. Coronary-artery bypass grafting. N Engl J Med 2016; 374(20): 1954-64.
- D'Agostino RS, Jacobs JP, Badhwar V, Paone G, Rankin JS, Han JM, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2017 update on outcomes and quality. Ann Thorac Surg 2017; 103(1): 18-24.
- Selnes OA, Gottesman RF, Grega MA, Baumgartner WA, Zeger SL, McKhann GM. Cognitive and neurologic outcomes after coronary-artery bypass surgery. N Engl J Med 2012; 366(3): 250-7.
- Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med 2002; 346(15): 1128-37.
- Ribeiro AL, Gagliardi SP, Nogueira JL, Silveira LM, Colosimo EA, Lopes do Nascimento CA. Mortality related to cardiac surgery in Brazil, 2000-2003. J Thorac Cardiovasc Surg 2006; 131(4): 907-9.
- Peterson ED, Coombs LP, DeLong ER, Haan CK, Ferguson TB. Procedural volume as a marker of quality for CABG surgery. JAMA 2004; 291(2): 195-201.
- Hasantash SA, Mirpoor K, Ahmadi Z. Cardiac surgery in an Iranian teaching Shahid Modares Hospital: Outcome and risk factors. Iran J Surg 2004; 12(33): 18-23. [In Persian].
- Fortescue EB, Kahn K, Bates DW. Development and validation of a clinical prediction rule for major adverse outcomes in coronary bypass grafting. Am J Cardiol 2001; 88(11): 1251-8.
- Ivanov J, Weisel RD, David TE, Naylor CD. Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery. Circulation 1998; 97(7): 673-80.
- Baskett R, Buth K, Ghali W, Norris C, Maas T, Maitland A, et al. Outcomes in octogenarians undergoing coronary artery bypass grafting. CMAJ 2005; 172(9): 1183-6.
- Yau TM, Fedak PW, Weisel RD, Teng C, Ivanov J. Predictors of operative risk for coronary bypass operations in patients with left ventricular dysfunction. J Thorac Cardiovasc Surg 1999; 118(6): 1006-13.
- Bradshaw PJ, Jamrozik K, Le M, Gilfillan I, Thompson PL. Mortality and recurrent cardiac events after coronary artery bypass graft: Long term outcomes in a population study. Heart 2002; 88(5): 488-94.
- Pepper J. Controversies in off-pump coronary artery surgery. Clin Med Res 2005; 3(1): 27-33.
- (18) Wu C, Camacho FT, Wechsler AS, Lahey S, Culliford AT, Jordan D, et al. Risk score for predicting long-term mortality after coronary artery bypass graft surgery. Circulation 2012; 125(20): 2423-30.
- Weintraub WS, Clements SD, Crisco LV, Guyton RA, Craver JM, Jones EL, et al. Twenty-year survival after coronary artery surgery: An institutional perspective from Emory University. Circulation 2003; 107(9): 1271-7.
- van Domburg RT, Kappetein AP, Bogers AJ. The clinical outcome after coronary bypass surgery: A 30-year follow-up study. Eur Heart J 2009; 30(4): 453-8.
- Loop FD, Lytle BW, Cosgrove DM, Stewart RW, Goormastic M, Williams GW, et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med 1986; 314(1): 1-6.