학술논문
Early and Mid-Term Outcomes of Coronary Artery Bypass Grafting in Adults With Congenital Heart Disease.
Document Type
Academic Journal
Author
Graham G; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Dearani JA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Abdelrehim AA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Miranda WR; Department of Cardiovascular Diseases, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota.; Schaff H; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Stulak JM; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Todd AL; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Stephens EH; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: Stephens.Elizabeth@mayo.edu.
Source
Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8917640 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-9488 (Electronic) Linking ISSN: 10430679 NLM ISO Abbreviation: Semin Thorac Cardiovasc Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Atherosclerotic coronary artery disease (CAD) is well-studied in acquired cardiac diseases; however, little data exist regarding outcomes of adult congenital heart disease (ACHD) with CAD. This study examined patients who underwent coronary artery bypass grafting (CABG) during repair of ACHD. This was a retrospective study of patients who underwent CABG for CAD concomitant with ACHD repair 1972-2021. Demographic information, ACHD diagnosis, surgical history, operative details, and outcomes were analyzed. Data are presented as median (interquartile range [IQR]). 157 patients were identified with a median age of 63 (IQR 17) years. Left anterior descending (LAD) was the predominant diseased artery (109 patients [69%]); of those 83 (76%) were treated with mammary artery. 90 (57.3%) patients had 1 bypass, 42 (26.7%) 2, 19 (12%) 3, and 6 (3.8%) had 4. There has been no early mortality since 1988. There was no long-term survival difference between the patients with LAD disease treated with mammary compared to vein (P = 0.68), but early mortality was higher in those treated with vein (10.3% vs 0%, P = 0.018). Late recurrent angina was found in 18 patients (12%) and recurrent CAD found in 17 patients (11%), with 16 patients (10%) requiring CAD reintervention. At most recent follow-up (7.2 [IQR 11.4] years), 101 (64.3%) patients were deceased at 10 (IQR 13.1) years after surgery. Surgical revascularization for CAD may be necessary during the treatment of ACHD, most commonly for LAD disease. Early mortality was low in recent decades. Continued surveillance for recurrent CAD is required.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
(Copyright © 2022 Elsevier Inc. All rights reserved.)