Early Outcome of Coronary Artery Bypass Grafting Combined with Coronary Endarterectomy

Andreas Willianto, Sylvie Sakasasmita, Heston Napitupulu, Royman Simanjuntak, Leonardo P. Suciadi, Antono Sutandar, Maizul Anwar

Siloam Heart Institute, Jakarta, Indonesia

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – C

Abstract

Objective

This study aimed to describe early outcome of coronary endarterectomy (CE) combined with coronary artery bypass graft (CABG) in the treatment of diffused coronary artery disease (CAD).

Methods

Patients who had CABG since January 2013 until December 2016 were included. They were divided into the CABG+CE (Group A) and isolated CABG (Group B). The primary end points were compared the in-hospital mortality, the ICCU stay and hospital stay between two groups. We also compared the mortality between two groups during follow up until June 2017. Patients having concomitant procedures and previous hemodialysis were excluded.

Results

From total 245 patients who underwent CABG, 103 patients (42.04%) required CE combined with CABG (Group A) and 142 patients (57.96%) received isolated CABG (Group B). The incidence of three vessels disease was higher in Group A (92.2% vs 81.6%; p = 0.018). Mean CPB time (105 min vs 98 min; p = 0.026) and AOX time (69 min vs 60 min; p <0.0001) were longer in Group A.

There were higher incidence of re-operative caused by bleeding (8.7% vs 2.1%; p = 0.018) and acute kidney injury (11.6% vs 4.9%; p = 0.05) in Group A. In hospital mortality and the incidence of major complication such as postoperative stroke, perioperative myocardial infarction (MI), ventricular arrhythmia, and new onset atrial fibrillation (AF) were similar between two groups. The length of ICCU and hospital stay were also similar. At follow up until June 2017 (mean 10.21 months), the survival rate was comparable in Group A and Group B (hazardous ratio = 2.17, 95% CI:0.44-10.77, p = 0.342).

Conclusion

CABG with CE shows satisfactory and comparable results to isolated CABG.