EARLY MORBIDITY AND MORTALITY IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT WITH AND WITHOUT CORONARY ENDARTERECTOMY. A SINGLE CENTRE EXPERIENCE

Abstract

Objective: To compare the early morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG) with and without coronary endarterectomy CE) in our hospital settings.

Study Design: Comparative prospective study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi Pakistan, from Jan 2019 to Jan 2021.

Methodology: Consecutive 1820 patients who fulfilled the inclusion criteria and underwent conventional coronary artery bypass grafting (were included in group “A”, while 130 patients who underwent coronary endarterectomy during coronary grafting were included in group “B”. We identified and compared the preoperative risk factors, early mortality and perioperative complications in our study.

Results: In our study the early mortality between both the groups i.e. conventional coronary artery bypass grafting (group A) and coronary artery bypass grafting with coronary endarterectomy (group B) was 3.1% and 5% (p=0.07). Amongst the perioperative and postoperative characteristics of patients in both the groups; CPB time, aortic X-clamp time, ICU stay, postoperative Max CKMB, inotropic requirement, hemodynamic instability requiring IABP, dysrhythmias, significant bleeding and LIMA as conduit were significant with the p-value<0.05. However, ventilation time, requirement of products (FFP, Platelets) and pleural effusion were non-significant.

Conclusion: Although early mortality in coronary artery bypass grafting with coronary endarterectomy is higher than the conventional coronary artery bypass grafting, but this difference is statistically insignificant. However, there is an evidence of higher perioperative complications in coronary endarterectomy group in comparison to conventional CABG.