Impact of Multiarterial Atherosclerotic Disease and Atherosclerosis-related Factors on Coronary Artery Bypass Grafting

Abstract

Objective: This study was conducted to investigate the perioperative and late-phase results of recently performed cases of coronary artery bypass grafting to clarify if multiarterial atherosclerotic disease and atherosclerosis-related factors have an impact on the results of coronary artery bypass grafting. Materials and Methods: The subjects were 101 consecutive cases undergoing only coronary artery bypass grafting. Preoperatively, atherosclerosis-related factors were measured and the presence or absence of multiarterial atherosclerotic disease was confirmed by diagnostic imaging in all cases, and the impact was retrospectively investigated. Results: There were 96 cases in the uneventful discharge group and 5 in the operative death (death within 30 days) group, and concomitant multiarterial atherosclerotic disease was present in 69 cases (72%) in the uneventful discharge group and 3 cases (60%) in the operative death group, respectively. In the operative death group, levels of glycated hemoglobin and triglycerides (TG), as well as the rate of hemodialysis, were significantly high. The most common concomitant atherosclerotic disease was brain lesions, and advanced calcification of the aorta and iliac arteries was also seen, but only one case of death was due to multiarterial atherosclerotic disease. Nine cases developed partial occlusion of the graft, and TG was significantly higher in this group compared to the group with completely patent grafts. Conclusion: We consider that it is possible to maintain good results of coronary artery bypass grafting in the presence of concomitant multiarterial atherosclerotic disease by performing preoperative systemic tests to be fully aware of the preoperative situation, and to take measures against complications. It is also necessary to strictly manage atherosclerosis-related factors.