Key result
Prior percutaneous coronary intervention before CABG was associated with higher postoperative mortality (15% vs 3%) and malignant arrhythmia (8% vs 1%) compared to CABG without prior PCI.
Why the study?
Does prior percutaneous coronary intervention increase postoperative mortality and morbidity in patients undergoing coronary artery bypass grafting?
Cohort (n=214)
No
Does prior percutaneous coronary intervention increase postoperative mortality and morbidity in patients undergoing coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
Patients undergoing CABG who have a history of prior PCI face significantly higher risks of postoperative mortality and major complications compared to those without prior PCI.
OBJECTIVE: In this study we compare the factors affecting mortality and morbidity of the patients had coronary artery bypass graft (CABG) with/without percutaneous coronary intervention (PCI) prior to the CABG operation.METHODS: In our study a total of 214 patients who underwent CABG in our hospital between January 2006-2008 were included. They were divided into two groups as A and B. In group A, 135 patients in whom CABG was performed after PCI (mean age 52.5±8.8 years) were included; in group B, 79 patients in whom CABG was performed without any coronary intervention (mean age 51.8±8.8 years) were included. Both groups were evaluated in terms of demographic characteristics, comorbid diseases and medications, preoperative ejection fraction (EF) and functional capacity, durations of preoperative cardiopulmonary bypass (CPB) and cross clamp, number of distal bypass, whether bypass was performed on the coronary artery undergoing PCI, inotropic agent or intra-aortic balloon pump support at the time of referring to postoperative intensive care unit (ICU), duration of postoperative ICU stay and complications.RESULTS: Of the patients, 85% were males and 15% were females. In 73% (n=98) of the patients undergoing CABG following PCI, bypass was performed also on the artery undergoing PCI. The rate of malignant arrhythmia was higher in the group A in which CABG was performed following PCI as compared to the group B (8% (n=11) in the group A, 1% (n=1) in the group B). The rate of development of cerebrovascular event (CVE) was 4% (n=5) in the group A and 1% (n=1) in the group B. Postoperative mortality was 15% (n=22) in the group A and 3% (n=2) in the group B.CONCLUSION: Although PCI may be a life-saving procedure in patients presenting with acute myocardial infarction, some serious complications may occur during the procedure. So an urgent surgical intervention may be necessary. In this study, mortality and morbidity of the CABG procedures performed after PCI are reported to be high.
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Aksoy et al. (2014) conducted a cohort in Patients undergoing coronary artery bypass graft (CABG) (n=214). Prior percutaneous coronary intervention (PCI) vs. CABG without prior PCI was evaluated on Postoperative mortality. Prior percutaneous coronary intervention before CABG was associated with higher postoperative mortality (15% vs 3%) and malignant arrhythmia (8% vs 1%) compared to CABG without prior PCI.
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