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Does Coronary Endarterectomy Increase Early Mortality and Morbidity Compared with Coronary Artery Bypass Surgery Alone-Single Centre Experience

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International Journal of Clinical Medicine 2014年第5期5卷 197-205页

作者： Mohammed Alreshidan Mohammed Albabtain hamoud obied Mohamed Alassal Abdulaziz Albaradai Fahad Alghofaili Cardiac Surgery Department Prince Salman Heart Centre (PSHC) King Fahad Medical City (KFMC) Riyadh KSA

Background: With increasing incidence of coronary artery disease (CAD) in Saudi Arabia and its fatal co-morbidity, this has resulted in a more complex pool of cases referred to cardiac surgeons. In selected cases, achieving optimal revascularization of diffuse CAD necessitates adjunctive techniques such as coronary endarterectomy (CE). The aim of our study is to evaluate the early mortality and post-operative morbidity related to CE. Method: Retrospective study from Jan 2009 to Dec 2010. Inclusion of 186 patients: 38 patients had CABG with CE and 148 patients had CABG alone. Results: Pre-operative percutaneous coronary intervention (PCI) was higher in the CE with CABG group (25.8%) compared with CABG alone (8.9%) (p = 0.009). Intra-operative data showed a higher mean cardiopulmonary bypass time (CBT) of 160 minutes and a mean cross-clamp time (XCT) of 109 minutes in the CE with CABG, compared to a mean CBT of 129 minutes and a mean XCT of 87 minutes in the CABG alone group (p = 0.001). The most common vessel endarterectomized was left anterior descending artery (LAD) (47%) followed by right coronary artery (RCA) (22%). Post-operatively, the mortality amongst the CE with CABG group (7.9%) was higher than CABG only group (1.4%), however it wasn’t statistically significant (p = 0.06). With regards to morbidity, hemodynamic instability requiring intra aortic balloon pump (HIR-IABP) was higher in the CE with CABG group (10.5%) compared to the CABG only group (1.4%) (p = 0.018). Conclusion: Our study showed that CE when combined with CABG wasn’t associated with a higher mortality rate when compared with CABG alone.

关键词： CABG Coronary Endarterectomy Mortality Morbidity

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Incidence &Risk Factors Associated with Carotid Disease in Patients Undergoing Coronary Artery Bypass Grafting Surgery

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Open Journal of Thoracic Surgery 2014年第2期4卷 17-20页

作者： hamoud obied Asim Miari Mohammed Alreshidan Fahad Alghofaili Mohammad Ibrahim Abdulaziz Albaradai Mohammed Koudieh Cardiac Surgery Department Prince Salman Heart Center Riyadh KSA

Objective: The purpose of this study was to evaluate the true incidence and the risk factors associated with carotid disease in the sitting of high risk patients undergoing coronary artery bypass graft (CABG) using carotid duplex scan and to find out if routine preoperative carotid duplex scan is needed among all these patients. Methods: This retrospective study included 402 consecutive patients who underwent bilateral carotid duplex scan admitted for CABG during the period from January 2006 to December 2008. We excluded patients in cardiogenic shock who were taken to operating room emergently. Results: The prevalence of associated risk factors showed diabetes mellitus recorded the highest (93.3%) whereas peripheral vascular disease the lowest (1.7%), hypertension (89.3%), dyslipidemia (72.6%), smoker (21.1%), left main disease (4.7%), and previous stroke (3%). Patients undergoing CABG has high incidence of carotid disease (68.7%) and severe stenosis is more in patients aged 60 and above (13.5%) versus (2.3%) in age 60, previous stroke and left main disease). Conclusion: This study showed that carotid screening is recommended for all patients who are undergoing CABG due to high incidence of carotid disease.

关键词： Carotid Artery Disease Coronary Artery Bypass Grafting Incidence Risk Factors Carotid Duplex Scan

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