title: Prognostic value of anatomical dominance of coronary circulation in patients with surgical myocardial revascularization.
abstract: BACKGROUND
  This study evaluated the frequency of domination of the coronary arteries types in patients treated by surgical myocardial revascularization. The aim of the study was to determine whether the left coronary circulation dominance is a prognostic factor for poorer outcome in patients undergoing coronary artery bypass surgery.
  
  
  METHODS
  A total sample consisted of 100 patients with coronary artery disease that were treated with coronary artery bypass grafting at the Clinic for Cardiac Surgery, Clinical Center of the University of Sarajevo. To all patients on the basis of preoperative coronary angiography was determined the dominance of the coronary arteries. Patients included in the study were divided into two groups, with the left and right with coronary dominance.
  
  
  RESULTS
  Left coronary dominance in a sample of patients was present in 21/100 (21%), right in 69/100 (69%) and balanced in 10/100 (10%) cases. Female gender was significantly more frequent in patients with left coronary dominance and proved to be a stronger predictor of poorer outcome, especially in combination with left main stenosis of the left coronary artery and left coronary dominance. Inability of revascularization of the r. interventricularis posterior (RIVP) was statistically significantly higher in case of left dominance 9/21 (42.9%), compared to the right 16/79 (20.3%), p=0.033. Lethal outcome was more common in case of left dominance in relation to the right (9.4% vs 0.9%). The incidence of surgical complications, respiratory, neurological and renal complications was not significantly different between groups, while the length of hospital stay was significantly higher in the group of patients with left dominance, p = 0.003.
  
  
  CONCLUSIONS
  Left coronary dominance is an important risk factor for patients undergoing surgical myocardial revascularization.
authors: Institute for Heart Disease, Cardiac Surgery Clinic, Clinical Center, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors: Edin
authors: E
authors: Omerbasic
authors: Department of Anatomy, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors: Aida
authors: A
authors: Hasanovic
authors: Policlinic "Atrijum", Sarajevo, Bosnia and Herzegovina.
authors: Amir
authors: A
authors: Omerbasic
authors: Institute for Heart Disease, Cardiac Surgery Clinic, Clinical Center, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors: Sanko
authors: S
authors: Pandur
mesh_terms: D000368:Aged; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
keywords: coronary angiography; dominance of the coronary arteries; surgical myocardial revascularization