Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective
Vishal Khullar, MBBS,
Eglal Ahmed, MBBS,
Kevin Greason, MD,
Kukbin Choi, MD,
John Stulak, MD,
Katherine King, MS,
Mauricio Villavicencio, MD,
Richard Daly, MD,
Joseph Dearani, MD,
Juan Crestanello, MD,
Hartzell Schaff, MD
Affiliations
Vishal Khullar, MBBS
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn; Address for reprints: Vishal Khullar, MBBS, Department of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Eglal Ahmed, MBBS
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Kevin Greason, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Kukbin Choi, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
John Stulak, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Katherine King, MS
Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minn
Mauricio Villavicencio, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Richard Daly, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Joseph Dearani, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Juan Crestanello, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Hartzell Schaff, MD
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
Objective: Concomitant coronary artery bypass grafting (CABG) and pericardiectomy (PC) can be a technically challenging operation. We sought to study the outcomes of patients undergoing concomitant PC and CABG. Methods: Between July 1983 and August 2016, 70 patients (median age, 67 years; 88% males) underwent concomitant PC and CABG (PC + CABG group). Multivariable analysis was used to identify predictors of mortality. Matched patients who underwent isolated PC (PC group) were identified, and postoperative outcomes and long-term survival in the 2 groups were compared. Results: Compared with the PC group, cardiopulmonary bypass time was significantly longer in the PC + CABG group (82 minutes vs 61 minutes; P < .001). In-hospital mortality was 4% in the PC group and 7% in the PC + CABG group (P = .380). Multivariable analysis identified peripheral vascular disease (hazard ratio [HR], 2.67; 95% CI, 1.06-6.76; P = .04) as a predictor of increased morbidity or mortality and a borderline association with New York Heart Association functional classes III and IV (HR, 2.41; 95% CI, 0.99-5.86; P = .05) with increased morbidity and mortality in the PC + CABG group. Kaplan–Meier estimates demonstrated similar late mortality rates in the 2 groups at a 15-year follow-up (P = .700). Conclusions: Concomitant PC and CABG is not associated with increased morbidity or mortality compared with isolated PC. Thus, CABG should not be denied at the time of PC.
