الفهرس | Only 14 pages are availabe for public view |
Abstract Objectives: The number of percutaneous coronary interventions (PCI) prior to coronary artery bypass grafting (CABG) increased drastically during the last decade. Patients are referred for CABG with more severe coronary pathology, which may influence postoperative outcome. Methodology: Outcomes of 200 CABG patients, collected by prospective multicenter randomized control study, were compared (mean follow-up: 3 months). Group I (n = 100, mean age 57.20 years, 9 women) underwent primary CABG and group II (n = 100, mean age 53.25, 18 women) had prior PCI before CABG. In group II, the mean number of administered stents was 1.98. Results: Patients with prior PCI presented for CABG with more severe CAD as evidenced by higher CCS classification score (P = 0.016), higher incidence of previous myocardial infarction (P = 0.004), unplanned CABG (P = 0.0000001), and higher mean EDD (P = 0.021). The total number of grafts was significantly higher in the non PCI group 3.12±0.73 vs. 2.46±0.85 (P value=0.00001), also the incidence of total revascularization was significantly higher in the non PCI group 79 vs 50 (P value=0.00001). Postoperative inotropic support usage, overall morbidity and the mean hospital stay were higher in the PCI group (P value=0.02, 0.01 and 0.000595 repectively). Post operative echo after 3 months showed higher EF (60.20% ±6.28 vs. 58%± 8-P value 0.0001) and better improvement of RSWMA and dimension (P value =0.0001, 0.048 respectively) in the non PCI group. Conclusion: Patients with prior PCI presented for CABG with more severe CAD. Morbidity, were significantly higher in patients with prior PCI but no difference in mortality. Postoperative echo emphasize lower benefit from CABG in patents coming with recurrence CAD post PCI. |