Thorac Cardiovasc Surg 2006; 54(4): 239-243
DOI: 10.1055/s-2005-873065
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Coronary Reconstructive Surgery versus Coronary Artery Bypass Grafting - A Documentation Gap

B. Osswald1 , U. Tochtermann1 , D. Badowski-Zyla1 , G. Thomas1 , S. Hagl1
  • 1Department of Cardiac Surgery, University of Heidelberg, Germany
Further Information

Publication History

Received February 23, 2005

Publication Date:
02 June 2006 (online)

Abstract

Objective: Over the last years, there has been a clear trend that an increasing number of patients are admitted for CABG with advanced disease, complex pathomorphological alterations and impaired left ventricular function. The necessity of performing extensive reconstructive coronary surgery rather than coronary bypass grafting, in its original sense, is not appropriately documented by the current version of the German Documentation System for Cardiac Surgery, nor in other national and international documentation systems. Patients and Methods: 5821 consecutive, unselected patients underwent isolated CABG from 7/1995 through 12/2003 at a single institution. A closing date follow-up procedure up to 8 years postoperatively was performed with a completeness of 98.8 %. Results: The need for reconstructive surgery in terms of extended anastomoses with or without coronary endarterectomy has doubled in our patients since 1995 and is steadily increasing with 15.7 % (n = 102) of these patients requiring such surgery in 2003. Current documentation does not allow any prediction of complex coronary morphology. The Kaplan-Meier survival curve reveals no substantial difference between patients with and without coronary reconstructive surgery up to 8 years after CABG. Conclusion: The increase of complexity in CABG procedures currently remains undetected, since preoperative imaging methods often fail to predict complex coronary morphology. Survival after coronary reconstructive surgery is comparable to that of “classical” CABG. Therefore, a standardized documentation is required to evaluate surgical results and to contribute to the improvement of medical decision-making which presupposes valid data.

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PD Dr. Brigitte Osswald

Department of Cardiac Surgery
Unversity of Heidelberg

Im Neuenheimer Feld 110

69120 Heidelberg

Germany

Phone: + 496221566111

Fax: + 49 62 21 56 40 46

Email: brigitte_osswald@med.uni-heidelberg.de