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Coronary artery bypass surgery in patients with low EuroSCORE preoperative risk

1Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia

2The Clinic for Cardiovascular Surgery, Clinical Center Serbia, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia

3Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia

© 2012 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. (CC BY-NC-ND 3.0)

Citation Information: Open Medicine. Volume 7, Issue 3, Pages 388–395, ISSN (Online) 2391-5463, DOI: 10.2478/s11536-011-0164-4, March 2012

Publication History

Published Online:
2012-03-29

Abstract

Patients with EuroSCORE <2 are usually considered to have a low surgical risk and the lowest mortality. In our study preoperative factors in a group of 250 consecutive low-risk patients (EuroSCORE<2), who underwent first isolated coronary artery by-pass surgery during 1999 and 2000., were analyzed. Cumulative follow-up period was 1178.48 patient-years and the primary clinical outcome was all-cause mortality. Patients’ average age was 59.2±7.5 yr. The following preoperative risk factors of increased 5-year mortality were identified: older age (P<0.001), smoking, prior non-recent myocardial infarction and reinfarction, anteroseptal localization of myocardial infarction (P<0.001), poor ejection fraction<=35% (P<0.001), dilatative cardiomyopathy (P<0.001), wall motion systolic index 〉2 (P<0.001), left atrial dilatation (P<0.001), mitral regurgitation more than 2+ (P<0.001), presence of left main disease, triple vessel coronary artery disease (P<0.001), absence of collaterals (P<0.001) and presence of more than 3 distal anastomoses. Through the present study it has been shown that it is possible to identify a subgroup of patients with low operative mortality and excellent 5-year survival after surgical treatment for coronary artery bypass surgery using preoperative clinical, echocardiographic, coronarographic and intraoperative data, even in difficult conditions of the civil war in the region.

Keywords: Cardiac surgery; Coronary artery bypass; Preoperative risk prediction; EuroSCORE

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