Long term survival after CABG: a single center experience

摘要

Introduction: Coronary artery bypass (CABG) is the preferred procedure for complete revascularization in patients with multi-vessel coronary artery disease. We analyzed evolving patient profile, early outcomes and late survival in patients undergoing CABG at our center over a 20 year period.Patients: Between 1993-2012, 4913 patients underwent CABG with or without concomitant procedures. A retrospective analysis was performed to determine early outcomes. Long-term survival was established from data from the Ministry of Interior.Results: Isolated CABG was performed in 3950 (80%). Over time, patients undergoing surgery are older (p=0.002) and the incidence of concomitant procedures increased from 20% to 61% (p<0.0001). Predicted operative mortality increased (p<0.0001) however observed mortality remained the same (p=0.5). Long-term survival was reduced in patients requiring concomitant procedures (p<0.0001) and in patients with reduced LV function (p<0.0001). Survival after isolated CABG is 86% and 70% at 5 and 10 years respectively. Late survival was affected by age and co-morbid conditions. Reduced LV function and the presence of preoperative mitral regurgitation emerged as cardiac predictors for late mortality.Conclusions: Patients undergoing CABG are older and have more extensive co-morbidity. Despite this, operative mortality has not increased. Long-term survival is affected by age, LV function and co-morbid conditions.