Off-pump coronary artery bypass grafting for poorly controlled diabetic patients.
OBJECTIVE
To estimate the postoperative outcome of off-pump coronary artery bypass grafting (OPCAB) for patients with poorly controlled diabetes mellitus as evaluated by preoperative hemoglobin A1c (HbA1c).


METHODS
The preoperative value of HbA1c in 101 diabetic patients who had undergone OPCAB from January 2000 to January 2007 was reviewed. A value of 6.5% was used as an indicator of poorly controlled hyperglycemia, and patients were distributed into a well-controlled group (group A: HbA1c <6.5, n = 47) or a poorly controlled group (group B: HbA1c >6.5, n = 54). The average follow-up period was 2.2 +/- 1.3 years.


RESULTS
There was no difference in the number of anastomoses (group A: 2.76 +/- 1.00 vs. group B: 2.63 +/- 0.80; p = 0.45) or the use of bilateral internal thoracic arteries (78.7% vs. 81.4%; p = 0.80). Postoperative angiography was carried out in 97 patients. The graft patency rate was 96.9% (126/130) in group A and 99.2% (131/132) in group B (p = 0.37). The stenosis free rate was 92.3% (120/130) in group A and 93.1% (123/132) in group B (p = 0.82). There were no operative deaths, no hospital deaths, and no late cardiac deaths. Postoperative atrial fibrillation occurred in 14 patients (29.7%) of group A and 12 (22.2%) of group B (p = 0.49). Wound dehiscence occurred in 2 patients (4.3%) of group A and 5 (9.3%) of group B (p = 0.44). Postoperative hospital stay lasted 22.1 +/- 9.5 days in group A and 21.7 +/- 9.1 days in group B (p = 0.86).


CONCLUSIONS
OPCAB is feasible in patients having poorly controlled diabetes mellitus, and their condition does not compromise the surgical outcome.
Matsuura
Kaoru
K
Division of Cardiovascular Surgery, Department of Surgery, Chiba University Hospital, Chiba, Japan.
Imamaki
Mizuho
M
Ishida
Atsushi
A
Shimura
Hitoshi
H
Niitsuma
Yuriko
Y
Miyazaki
Masaru
M
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D048909:Diabetes Complications / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human