Omar Amr S, Hanoura Samy, Shouman Yasser, Sivadasan Praveen C, Sudarsanan Suraj, Osman Hany, Pattath Abdul Rasheed, Singh Rajvir, AlKhulaifi Abdulaziz
Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Unit, Hamad Medical Corporation, Doha 3050, DA, Qatar.
Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar.
World J Crit Care Med. 2021 Jan 9;10(1):12-21. doi: 10.5492/wjccm.v10.i1.12.
Left main coronary artery (LMCA) supplies more than 80% of the left ventricle, and significant disease of this artery carries a high mortality unless intervened surgically. However, the influence of coronary artery bypass grafting (CABG) surgery on patients with LMCA disease on morbidity intensive care unit (ICU) outcomes needs to be explored. However, the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring.
To determine whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome.
Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG. Patients were divided into 2 groups; those with LMCA disease as group 1 (75 patients) and those without LMCA disease as group 2 (324 patients). We correlated ICU outcome parameters including ICU length of stay, post-operative atrial fibrillation, acute kidney injury, re-exploration, perioperative myocardial infarction, post-operative bleeding in both groups.
Patients with LMCA disease had a significantly higher prevalence of diabetes (43.3% 29%, = 0.001). However, we did not find a statistically significant difference with regards to ICU stay, or other morbidity and mortality outcome measures.
Post-operative performance of Patients with LMCA disease who underwent CABG were comparable to those without LMCA involvement. Diabetes was more prevalent in patients with LMCA disease. These findings may help in guiding decision making for future practice and stratifying the patients' care.
左冠状动脉主干（LMCA）为左心室供血超过80%，该动脉的严重病变若不进行外科干预则死亡率很高。然而，冠状动脉旁路移植术（CABG）对患有LMCA疾病患者在重症监护病房（ICU）的发病率及预后的影响尚需探索。不过，CABG手术对患有LMCA疾病的ICU患者发病率的影响值得研究。
确定LMCA疾病是否是以ICU住院时间延长作为主要结局以及以ICU住院期间的早期发病率作为次要结局的决定性危险因素。
采用回顾性描述性研究，通过目的抽样分析399例行单纯急诊或择期CABG的患者。患者分为两组；患有LMCA疾病的为第1组（75例患者），未患有LMCA疾病的为第2组（324例患者）。我们对两组患者的ICU结局参数进行了相关性分析，包括ICU住院时间、术后房颤、急性肾损伤、再次手术探查、围手术期心肌梗死、术后出血情况。
患有LMCA疾病的患者糖尿病患病率显著更高（43.3%对29%，P = 0.001）。然而，我们未发现两组在ICU住院时间或其他发病率及死亡率结局指标方面存在统计学显著差异。
接受CABG的患有LMCA疾病患者的术后表现与未累及LMCA的患者相当。糖尿病在患有LMCA疾病的患者中更为普遍。这些发现可能有助于指导未来实践中的决策制定及对患者护理进行分层。
