[Coronary artery bypass grafting in diabetic patients: early and mid-term outcomes]. / La chirurgie du pontage aorto coronaire chez les diabétiques : Résultats immédiats et à moyen terme.

BACKGROUND: The outcome of coronary artery bypass grafting (CABG) in diabetic patients has traditionally been worse than in nondiabetic patients. Recent studies have suggested an improvement in outcome in diabetic patients undergoing CABG. However, the direct impact of diabetes on mortality and morbidities following CABG remains unclear. AIM: To evaluate the early and mid term outcomes of diabetic patients compared to non-diabetics following CABG. METHODS: We retrospectively analyzed the data of 228 CABG patients from January 2005 to December 2010: one hundred and twenty-six diabetics and 102 non-diabetic.Diabetic patients were more likely to be female(27% Vs 12.7% P=0.009) were less smoker (55.6% Vs 80.4% P<0.0001) with higher rate of three vessel disease(67.5% Vs 42.2% P=0.005) compared to non-diabetics. RESULTS: Hospital mortality was significantly higher among diabetic patients (16% Vs 4.1% P=0.005).Length of care unit stay was more important (2.3 days Vs 2.1 days P=0.048) , but with a similar rate of sternal wound infection even after bilateral internal thoracic artery grafting. After 28 months mean follow- up, mid-term survival of diabetics was significantly decreased compared to no-diabetics (91% Vs 99% p<0.001) .However, Event-free survival was similar in the two groups (76% Vs 80% p=0.82). CONCLUSION: These results suggest that diabetes is associated with poorer early and mid-term outcomes following (CABG).

[Atrial fibrillation following coronary artery bypass grafting: predictors and mid- term outcome]. / La fibrillation atriale aprés chirurgie de pontage aortocoronaire: facteurs prédictifs et pronostic àà moyen terme.

BACKGROUND: Atrial fibrillation (AF) is a frequent complication after coronary artery bypass grafting (CABG) which increase morbidity and hospitalization length. AIM: To identify the predictors of atrial fibrillation and its repercussion on hospital and mid-term outcomes in patients undergoing (CABG). METHODS: We undertook a retrospective review of the data of 224 patients undergoing CABG. The mean age of the patients was 60.8 years. Atrial fibrillation was diagnosed from serial postoperative electrocardiogram. RESULTS: Twenty two patients developed postoperative atrial fibrillation. Multivariate analysis showed that only: age, left circumflex stenosis, sternal wound infection and low cardiac output were predictors of AF following CABG. Hospital mortality was similar in the two groups (5% Vs 9.6 % P=0.7). CONCLUSION: In our study, the incidence of post-CABG atrial fibrillation was 9.8%. Multivariate predictors were age, left circumflex lesion, sternal wound infection and low cardiac output. Hospital mortality and mid-term outcome were similar in the two groups.

[Single versus bilateral internal thoracic artery grafts for multi vessel coronary artery bypass grafting: mid-term results]. / Mono-pontage versus pontage bilatéral mammaire interne : Résultats immédiats et à moyen terme.

BACKGROUND: The issue of superiority of single internal thoracic artery grafting versus bilateral internal thoracic artery grafting remains unresolved. AIM: The aim of this study was to compare the early results and midterm outcome of single and bilateral internal thoracic artery grafting for multivessel coronary artery bypass grafting. METHODS: Between January 2005 and March 2010, 196 patients underwent primary coronary artery bypass grafting with at least one internal thoracic artery grafts. Early results and Outcomes of patients undergoing single internal thoracic artery (SIMA) plus saphenous vein grafting (n=145) and bilateral internal thoracic artery (BIMA) plus saphenous vein grafting (n=51) were obtained at a mean followup of 29 months. RESULTS: Patients with bilateral internal thoracic artery grafting were younger, had less hypertension, higher left main disease and better Euroscore than patients undergoing single internal thoracic artery grafting. In-hospital mortality was similar for the two groups: 6.9 % for patients undergoing SIMA versus 5.9 % for those undergoing BIMA (p=0.8). Sternal wound infection was also similar (2.8% versus 3.9% p=0.68). Mid-term mortality was (4% VS 4.8% p=0.71) and event free survival probability at 28 months was 75% for the single-graft group compared with 85.7% for the bilateral-graft group (P =0.46). CONCLUSION: Our study found similar early and mid-term clinical outcomes for patients undergoing SIMA plus saphenous vein grafting and those undergoing BIMA plus saphenous vein grafting for multivessel coronary artery bypass grafting.