title: Long-term outcomes and risk analyses of coronary bypass for left main disease.
abstract: BACKGROUND
  We retrospectively analyzed the long-term outcomes and risk predictors of conventional coronary artery bypass grafting routinely employed for patients with left main disease.
  
  
  METHODS
  From January 2000 through December 2009, conventional coronary artery bypass grafting was routinely employed in 193 consecutive patients with left main disease. Long-term analyses were performed, looking at the primary endpoint of major adverse cardiac and cerebrovascular events which included all-cause death, stroke, myocardial infarction, and repeat revascularization. We also analyzed the effects of variables on major adverse cardiac and cerebrovascular events at 9 years after the operation.
  
  
  RESULTS
  The overall 9-year rates of combined outcomes (death, stroke, myocardial infarction), repeat revascularization, and major adverse cardiac and cerebrovascular events were 20.2%, 8.9%, 27.7%, respectively. The SYNTAX score was demonstrated to be the only significant predictor of combined outcomes at 9 years (hazard ratio 1.04, p = 0.033), repeat revascularization at 9 years (hazard ratio 1.11, p = 0.0030), and major adverse cardiac and cerebrovascular events at 9 years (hazard ratio 1.07, p = 0.0003).
  
  
  CONCLUSIONS
  With our routine strategy of conventional coronary artery bypass for left main disease, patients revealed excellent long-term outcomes in terms of major adverse cardiac and cerebrovascular events. These results provide a suitable benchmark against which long-term outcomes of percutaneous coronary intervention for left main disease can be compared. The SYNTAX score, which was introduced to determine treatment for complex coronary disease, is indicative of long-term outcomes after coronary artery bypass for left main disease.
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan ynoricho@tokai-u.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shimura
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Aki
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Furuya
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ueda
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Coronary artery bypass; SYNTAX score; Stroke; left main disease; major adverse cardiac and cerebrovascular event; myocardial infarction; percutaneous coronary intervention; repeat revascularization