title: Combined Coronary Revascularization: Single-Center 10-Year Experience.
abstract: OBJECTIVE
  This study aimed to assess the long-term outcome of combined coronary revascularization.
  
  
  METHODS
  Between January 2000 and September 2010, 106 consecutive patients underwent combined coronary revascularization, either the same day or staged within 90 days. Percutaneous coronary intervention was always performed before coronary artery bypass grafting. We identified three groups as follows: one-stop combined coronary revascularization (n = 20), percutaneous coronary intervention for acute coronary syndrome before subsequent surgery (n = 39), and percutaneous coronary intervention for stable coronary artery disease before subsequent surgery (n = 47). Off-pump technique was used in all cases.
  
  
  RESULTS
  A total of 107 angioplasties were realized (drug-eluting stents, 21; bare metal stents, 114; balloon angioplasty, 4). Percutaneous coronary intervention was mostly performed in the right coronary artery or branches (85%). The mean (SD) number of grafts was 1.9 (0.6), among them 1.8 (0.7) with arterial grafts. A total of 87.7% of the patients underwent exclusive arterial revascularization. There was one reexploration for bleeding and no in-hospital death. Eleven patients died in the follow-up. Repeat percutaneous coronary intervention was necessary for six patients and repeat surgery for one patient. The mean (SD) follow-up was 6.1 (2.7) years. Complete follow-up was obtained in 96.2% of the patients. Freedom from ischemic events (all-cause deaths, angina, acute coronary syndrome, myocardial infarction) was 86.3% (3.7%) at 5 years and 79.7% (5.2%) at 8 years (no difference between groups). Freedom from major adverse cardiac or cerebrovascular events was 88.8% (3.4%) at 5 years and 75.7% (5.2%) at 8 years (no difference between groups).
  
  
  CONCLUSIONS
  Combined coronary revascularization increases the use of arterial grafts, with good long-term outcome.
authors.affiliation: From the *Thoracic and Cardiovascular Surgery and †Cardiology Department, and ‡Cardiac Intensive Care Unit and Anesthesiology, University Hospital of Rennes, University of Rennes, Rennes, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Aymami
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
authors.forename: Simon
authors.initials: S
authors.lastname: Rouzé
authors.forename: Erwan
authors.initials: E
authors.lastname: Flécher
authors.forename: Julien
authors.initials: J
authors.lastname: Guihaire
authors.forename: Amedeo
authors.initials: A
authors.lastname: Anselmi
authors.forename: Majid
authors.initials: M
authors.lastname: Harmouche
authors.forename: Thierry
authors.initials: T
authors.lastname: Langanay
authors.forename: Dominique
authors.initials: D
authors.lastname: Boulmier
authors.forename: Antoine
authors.initials: A
authors.lastname: Roisne
authors.forename: Alain
authors.initials: A
authors.lastname: Leguerrier
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Verhoye
authors.forename: Hervé
authors.initials: H
authors.lastname: Corbineau
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000379:methods* / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome