JTCVS Open (Mar 2023)

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

Journal volume & issue
Vol. 13
pp. 178 – 183

Abstract

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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.

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