Does the completeness of revascularization contribute to an improved early survival in patients up to 70 years of age?
OBJECTIVE
In the era of a renewal of incomplete revascularization approaches, the controversy reappears as to whether the approach for complete revascularization is of prognostic value. The clear advantage of complete revascularization in elderly patients has recently been published. However, for the younger patient group, there is no conclusive information available so far. The aim of our study was to investigate the effect of complete vs. incomplete revascularization in patients up to 70 years of age.


METHODS
6531 patients underwent isolated CABG. 5003 of these patients were aged up to 70 years at the time of operation.


RESULTS
Incomplete revascularization was performed in 534 (10.7 %) patients. The most common reasons for incomplete revascularization were small vessels and massive calcification. The differences in mortality up to the 180(th) day after CABG are statistically significant. By Kaplan-Meier analysis, the time relationship between incomplete revascularization and death affects predominantly the very early period after CABG. By logistical regression, incomplete revascularization was found to be an independent risk factor for death after CABG.


CONCLUSIONS
Incomplete revascularization affects the early outcome after CABG in patients up to 70 years of age as an independent risk factor for death. In view of recent approaches for primarily incomplete CABG, our results indicate the necessity to reconsider the advantages of complete revascularization.
Osswald
B R
BR
Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Brigitte_osswald@med.uni-heidelberg.de
Tochtermann
U
U
Schweiger
P
P
Thomas
G
G
Vahl
C F
CF
Hagl
S
S
D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012307:Risk Factors; D013525:Surgical Instruments; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome