Effects of the Presence of Left Main Coronary Artery Disease on the Results of Off-pump Coronary Artery Bypass Grafting Surgery

Background: Left main coronary artery (LMCA) disease is one of the risk factors that affect the outcomes of coronary artery bypass grafting surgery. In particular, this risk factor pertains to the conduct of conventional on-pump CABG. Very little is known about the effects of the presence of LMCA disease on the results of off-pump CABG (OPCABG) surgery. Material and Methods: In the Department of Cardiac Surgery of the Republican Specialized Center of Cardiology, during the period between April 2015 and April 2017, 270 consecutive OPCABG procedures were performed. Patients were divided into 2 groups depending on the presence or absence of LMCA disease. Group 1 consisted of 124(44.9%) patients with LMCA disease, and Group 2 consisted of 146(55.1%) patients without LMCA lesions (non-LMCA group). Results: The average number of distal anastomoses in both groups was more than 3 anastomoses/patient. The incidence of nonfatal intraoperative complications was 8.9% in Group 1 and 15.1% in Group 2 (P=0.1212). The conversion rate to on-pump CABG amounted to 3.2% (4 patients) in Group 1 and to 4.8% (7 patients)in Group 2. In the immediate postoperative period, 40(32.2%) patients of Group 1 and 45(30.8%) of Group 2 needed inotropic support until full restoration of normal hemodynamics with duration between 3.0 and 2.6 hours. The average duration of ventilation support was 6.4 hours in Group 1 and 5.6 hours in Group 2. Hospital mortality was 0.8% (1 patient) in Group 1 and 0.7% (1 patient) in Group 2 (P>0.05). Conclusion: Thus, the presence of left main stem lesion of LCA is not an additional risk factor that would complicate the performance of OPCABG surgery. The OPCABG operation in this group of patients is a safe method and can be performed without compromising the completeness of myocardial revascularization with the same low mortality as in low-risk patients