Off-Pump Coronary Artery Bypass Grafting is Associated With Reduced Operative Mortality and In-Hospital Adverse Events in Patients With Left Main Coronary Artery Disease

摘要

Objective: Left main coronary artery disease (LMD) is a known risk factor for perioperative complications? This study compares off-pump coronary artery bypass (OPCAB) versus on-pump coronary artery bypass (ONCAB) grafting, CABG, with respect to in-hospital death, stroke, myocardial infarction, and major adverse cardiac events (MACE) in CABG patients with and without LMD. Methods: Among 13,108 consecutive isolated patients with CABG treated from 1997 to 2007, 2891 patients (22.1%) were preopera-tively found to have LMD. Of 5917 patients with OPCAB, 1276 (21.6%) had LMD, whereas among patients with ONCAB, 1615 of 7191 (22.5%) had LMD. Surgery type, LMD, and their interaction were examined for their impact on operative mortality, stroke, myocardial infarction, and MACE via multiple logistic regression models and adjusted odds ratios (AOR).Results: Utilization of OPCAB for coronary revascularization in patients with LMD disease gradually increased from an initikl ,low of 1.3% of patients in 1997 to a peak of 80.8% in 2007. OPC