Role of left main coronary artery stenosis on intraoperative conversion and mortality in off-pump coronary artery bypass

Jeng Wei Chen, Cheng Hsin Lin, Ron Bin Hsu

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Background: Intraoperative conversion is a major threat in off-pump coronary artery bypass (OPCAB). The conversion rate depends on patient selection and surgeon experience. Previous studies have demonstrated the feasibility of OPCAB for patients with left main coronary artery stenosis (LMCAS)≥50%. However, no studies have focused on the role of LMCAS≥90%.We sought to assess the impact of LMCAS≥90% on the conversion rate and mortality in OPCAB. Methods: We conducted a retrospective review of 1055 consecutive unselected patients undergoing OPCAB between 2000 and 2012. The patients in our study were divided into 3 groups by the severity of LMCAS. Results: LMCAS was <50% in 704, 50-90% in 266, and≥90% in 85 patients. LMCAS was not associated with major postoperative complications and hospitalmortality, although preoperative cardiogenic shock was present in 6.3%. Overall, the conversion rate was 10.1%:11.4% in LMCAS <50%, 5.6% in LMCAS 50-90%, and 14.1% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and operation before 2007were noted as independent predictors of conversion. The overall hospitalmortality rate was 5.1%: 4.8% in LMCAS <50%, 4.5% in LMCAS 50-90%, and 9.4% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and intraoperative conversion were observed to be independent predictors of mortality. However, LMCAS did not predict either conversion or hospital mortality. Conclusions: LMCAS≥90% was not an independent predictor of intraoperative conversion or hospital mortality in OPCAB.

原文英語
頁(從 - 到)522-528
頁數7
期刊Acta Cardiologica Sinica
30
發行號6
DOIs
出版狀態已發佈 - 十一月 9 2014
對外發佈Yes

指紋

Off-Pump Coronary Artery Bypass
Coronary Stenosis
Mortality
Cardiogenic Shock
Hospital Mortality
Stroke Volume
Patient Selection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

引用此文

Role of left main coronary artery stenosis on intraoperative conversion and mortality in off-pump coronary artery bypass. / Chen, Jeng Wei; Lin, Cheng Hsin; Hsu, Ron Bin.

於: Acta Cardiologica Sinica, 卷 30, 編號 6, 09.11.2014, p. 522-528.

研究成果: 雜誌貢獻文章

@article{4f3fc1d7ab844a9fa82b7c4cfc2e6a3c,
title = "Role of left main coronary artery stenosis on intraoperative conversion and mortality in off-pump coronary artery bypass",
abstract = "Background: Intraoperative conversion is a major threat in off-pump coronary artery bypass (OPCAB). The conversion rate depends on patient selection and surgeon experience. Previous studies have demonstrated the feasibility of OPCAB for patients with left main coronary artery stenosis (LMCAS)≥50{\%}. However, no studies have focused on the role of LMCAS≥90{\%}.We sought to assess the impact of LMCAS≥90{\%} on the conversion rate and mortality in OPCAB. Methods: We conducted a retrospective review of 1055 consecutive unselected patients undergoing OPCAB between 2000 and 2012. The patients in our study were divided into 3 groups by the severity of LMCAS. Results: LMCAS was <50{\%} in 704, 50-90{\%} in 266, and≥90{\%} in 85 patients. LMCAS was not associated with major postoperative complications and hospitalmortality, although preoperative cardiogenic shock was present in 6.3{\%}. Overall, the conversion rate was 10.1{\%}:11.4{\%} in LMCAS <50{\%}, 5.6{\%} in LMCAS 50-90{\%}, and 14.1{\%} in LMCAS≥90{\%}. Operation status, cardiogenic shock, left ventricular ejection fraction <30{\%} and operation before 2007were noted as independent predictors of conversion. The overall hospitalmortality rate was 5.1{\%}: 4.8{\%} in LMCAS <50{\%}, 4.5{\%} in LMCAS 50-90{\%}, and 9.4{\%} in LMCAS≥90{\%}. Operation status, cardiogenic shock, left ventricular ejection fraction <30{\%} and intraoperative conversion were observed to be independent predictors of mortality. However, LMCAS did not predict either conversion or hospital mortality. Conclusions: LMCAS≥90{\%} was not an independent predictor of intraoperative conversion or hospital mortality in OPCAB.",
keywords = "Conversion, Left main coronary artery stenosis, Off-pump coronary artery bypass",
author = "Chen, {Jeng Wei} and Lin, {Cheng Hsin} and Hsu, {Ron Bin}",
year = "2014",
month = "11",
day = "9",
doi = "10.6515/ACS20140929A",
language = "English",
volume = "30",
pages = "522--528",
journal = "Acta Cardiologica Sinica",
issn = "1011-6842",
publisher = "Republic of China Society of Cardiology",
number = "6",

}

TY - JOUR

T1 - Role of left main coronary artery stenosis on intraoperative conversion and mortality in off-pump coronary artery bypass

AU - Chen, Jeng Wei

AU - Lin, Cheng Hsin

AU - Hsu, Ron Bin

PY - 2014/11/9

Y1 - 2014/11/9

N2 - Background: Intraoperative conversion is a major threat in off-pump coronary artery bypass (OPCAB). The conversion rate depends on patient selection and surgeon experience. Previous studies have demonstrated the feasibility of OPCAB for patients with left main coronary artery stenosis (LMCAS)≥50%. However, no studies have focused on the role of LMCAS≥90%.We sought to assess the impact of LMCAS≥90% on the conversion rate and mortality in OPCAB. Methods: We conducted a retrospective review of 1055 consecutive unselected patients undergoing OPCAB between 2000 and 2012. The patients in our study were divided into 3 groups by the severity of LMCAS. Results: LMCAS was <50% in 704, 50-90% in 266, and≥90% in 85 patients. LMCAS was not associated with major postoperative complications and hospitalmortality, although preoperative cardiogenic shock was present in 6.3%. Overall, the conversion rate was 10.1%:11.4% in LMCAS <50%, 5.6% in LMCAS 50-90%, and 14.1% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and operation before 2007were noted as independent predictors of conversion. The overall hospitalmortality rate was 5.1%: 4.8% in LMCAS <50%, 4.5% in LMCAS 50-90%, and 9.4% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and intraoperative conversion were observed to be independent predictors of mortality. However, LMCAS did not predict either conversion or hospital mortality. Conclusions: LMCAS≥90% was not an independent predictor of intraoperative conversion or hospital mortality in OPCAB.

AB - Background: Intraoperative conversion is a major threat in off-pump coronary artery bypass (OPCAB). The conversion rate depends on patient selection and surgeon experience. Previous studies have demonstrated the feasibility of OPCAB for patients with left main coronary artery stenosis (LMCAS)≥50%. However, no studies have focused on the role of LMCAS≥90%.We sought to assess the impact of LMCAS≥90% on the conversion rate and mortality in OPCAB. Methods: We conducted a retrospective review of 1055 consecutive unselected patients undergoing OPCAB between 2000 and 2012. The patients in our study were divided into 3 groups by the severity of LMCAS. Results: LMCAS was <50% in 704, 50-90% in 266, and≥90% in 85 patients. LMCAS was not associated with major postoperative complications and hospitalmortality, although preoperative cardiogenic shock was present in 6.3%. Overall, the conversion rate was 10.1%:11.4% in LMCAS <50%, 5.6% in LMCAS 50-90%, and 14.1% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and operation before 2007were noted as independent predictors of conversion. The overall hospitalmortality rate was 5.1%: 4.8% in LMCAS <50%, 4.5% in LMCAS 50-90%, and 9.4% in LMCAS≥90%. Operation status, cardiogenic shock, left ventricular ejection fraction <30% and intraoperative conversion were observed to be independent predictors of mortality. However, LMCAS did not predict either conversion or hospital mortality. Conclusions: LMCAS≥90% was not an independent predictor of intraoperative conversion or hospital mortality in OPCAB.

KW - Conversion

KW - Left main coronary artery stenosis

KW - Off-pump coronary artery bypass

UR - http://www.scopus.com/inward/record.url?scp=84922981581&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922981581&partnerID=8YFLogxK

U2 - 10.6515/ACS20140929A

DO - 10.6515/ACS20140929A

M3 - Article

AN - SCOPUS:84922981581

VL - 30

SP - 522

EP - 528

JO - Acta Cardiologica Sinica

JF - Acta Cardiologica Sinica

SN - 1011-6842

IS - 6

ER -