Early and long-term results of surgical treatment of patients with acute coronary syndrome and left main coronary artery

Aims: to analyze the risk factors for postoperative complications and study long-term outcomes of off-pump CABG surgery in patients with left main disease and acute coronary syndrome. Materials and methods: we performed a prospective study of surgical treatment of 112 patients with ACS and left main disease. The control group included 82 patients with stable CAD. All patients underwent off-pump CABG surgery. The groups did not differ in age, gender and the Charlson comorbidity index. Risk factors for postoperative complications and intrahospital --mortality were analyzed. General and cardiac mortality, freedom from nonfatal myocardial infarction, stroke, and angina pectoris were studied in long-term period. Results: the incidence of early complications (cardiovascular, pulmonary, and renal) in the main and control groups were 22.3 and 23.2%, respectively, p = 0.89. The risk factors for postoperative complications in ACS were the age of patients >70 years, EuroSCORE II >7 and >5%, stenosis of left main coronary artery >70%, as well as transfusion of blood components in the early postoperative period. Intrahospital mortality in the study group was 3.6%, in the control group 2.4%, p = 0.6. The survival rate according to the Kaplan-Mayer curves in the period up to 8 years were 87 and 84%, respectively, p = 0.67. Conclusions: off-pump CABG in ACS allows achieving satisfactory results, both in the early and long-term period. Left main disease more than 70%, elderly age, EuroSCORE II more than 5% were predictors of early postoperative complications.