Coronary Artery Bypass Grafting In Young Patients: A Retrospective Review at Queen Alia Heart Institute

Abstract

Background: Coronary artery bypass grafting (CABG) is the ‘Gold Standard’ for patients with multiple vessel coronary artery disease (CAD). Younger patients presenting with coronary artery disease requiring surgery may represent a distinct subgroup with the main goal for coronary revascularization being long term patency of the performed grafts to improve outcome. Objective: The aim of this study was to check if young patients need surgery urgently for operative revascularization or electively. Also, check the potential advances regarding long-term patency using combined venous and arterial revascularization, and finally the overall mortality in young group of patients after CABG. Methods: Between January 2018 to January 2022, 526 patients below the age of 50 years underwent Coronary Artery Bypass Grafting CABG for coronary artery disease CAD in Queen Alia Heart Institute QAHI, We retrospectively analyzed the perioperative data and evaluated patients’ outcome. Results: In 25% of the patients, CABG was performed as an emergency procedure for STEMI or NSTEMI within 36 hours. Another 27% of the patients were operated urgently for unstable angina or myocardial infarction within the last weeks and only 48% of the patients were purely elective cases. We performed only venous bypass grafts in 12%, and combined venous and arterial revascularization in 88%. Patients received 2.8 ± 1 bypass grafts overall. Overall in-hospital mortality in this cohort was low with 1% (n = 1). Conclusions: The majority of the young patients below the age of 50 years present urgently for operative revascularization. Besides, the potential advances regarding long-term patency using total arterial revascularization, only about half of the young patients are feasible for this approach. Overall, early outcome in this group is excellent with mortality below one percent.