Abstract
We assessed the mid-term and long-term results of the coronary artery bypass grafting (CABG) for 121 patients with left main disease and complex coronary artery disease and compared with the 5-year results of the SYNTAX trial. Off-pump CABG (OPCAB) was performed in 108 patients (89.3%). The number of the distal anastomoses was 3.7 grafts, and the internal thoracic artery was used for the left anterior descending artery in 117 patients (96.7%). The mean number of arterial grafts used in each patient was 1.8 grafts. Although the rate of cerebrovascular events in CABG group of the SYNTAX trial was 2.7% in the first year, there was no perioperative cerebrovascular event in our patients, but the rate was increased to 4.2% during the 5-year follow-up, which was similar to the results of the SYNTAX trial. The rate of myocardial infarction (5.0%) was similar to the results of the SYNTAX trial. The rate of repeat revascularization, major adverse cardiac and cerebral events (MACCE), and cardiac death was 6.3%, 12.8%, and 2.9%, respectively, which were much lower than those of the SYNTAX trial. The results suggests that the strategy of complete revascularization by OPCAB can be the first choice for patients with left main and complex coronary artery disease and provide the excellent mid-term and long-term outcome.
