Total arterial coronary revascularization and factors influencing in-hospital mortality

^a Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
^b Department of Anaesthesia, The Royal Melbourne Hospital, Parkville, Victoria, Australia

Corresponding author. Suite 3, Private Medical Centre, P.O. Box 2135, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. Tel.: 3−9342−8908; fax: 3−9342−8908
e−mail: alistair.royse@nwhcn.org.au

Objective: To determine if arterial conduit selection or moreefficient arterial revascularization techniques influence in-hospitalmortality. Methods: Data from patients undergoing coronary arterybypass surgery at Royal Melbourne Hospital, Australia, between1 January 1996 and 30 June 1998 (n = 1681) was collected prospectively.Logistic regression analysis was performed. Results: Independentpreoperative predictors of increased in-hospital mortality includedrenal failure, redo coronary artery surgery and intra-aorticballoon pump use. In-hospital mortality for total arterial revascularization0.7%, radial artery use 0.9%, pedicled arterial revascularization0.2%, composite arterial conduit 0.4%, and the exclusive Y graftoperation 0.3%. These were all associated with reduced in-hospitalmortality. Mortality when vein graft was used was 2.9%. Mostpatients received total arterial revascularization, which wasconsidered the primary surgical strategy. Conclusion: Totalarterial revascularization, radial artery use and complex arterialreconstructions were associated with reduced in-hospital mortality.Preoperative renal failure, intra-aortic balloon pump use andredo coronary surgery predicted greater in-hospital mortality.

Поделиться: