Bilateral Internal Mammary Arteries for Coronary Revascularization in Patients with COPD

Background: COPD is one of the comorbidities that known to have a negative influence oncoronary artery bypass grafting outcomes , mainly sternal wound infection and long term survival. In this study we examined our outcome of COPD patients after CABG with BIMA grafts

Methods: Between 2006 and 2015 we preformed 1752 BIMA CABGs . Among them 42 patient were COPD patients. No significant differences regarding preoperative data were noticed between the COPD BIMA and the non COPD BIMA groups regarding age (62.6 ± 8 versus 59.9 ± 9 years; P = .6), gender (female percentage) ( 8% versus 13.1% ; P = .21 ) , BMI (27.8 ± 4.5 versus 28.2 ± 4.2 kg/m2; P = .58), diabetes mellitus (42% versus 41%; P = 1), EuroSCORE (6.2 ± 5.6 23 versus 4.3 ± 4.32; P = .11) and severe LV dysfunction (13.15% versus 12.44%; P = .9).

Results: No remarkable differences were noticed between the two groups regarding the number of distal anastomoses (3.55 ± 09 versus 3.78 ± 1; P = .12), total operation time (220.17 ± 35.06 versus 209.5 ± 29.24 min; P = .45), postoperative stroke (0% versus 0.88%; P = .5), myocardial infarction (0% versus 0.17%; P = .8), re-exploration (2.63% versus 2.69%; P = .96), deep sternal wound infection (0% versus 0.62%; P = .2) and postoperative atrial fibrillation ( 18.4% versus 20.1%; P=.7 ). The trend for 30-day mortality was higher in the COPD BIMA group (2.63% versus 0.82%; P = 0.49) while long term mortality was trending up in the non COPD group (4.8% versus 2.6%; P=0.2 ). However, there was no significant difference in total mortality between the groups (0.05% in both groups; P=1)

Conclusion:

Bilateral BIMA grafts can be appropriate for COPD patients with no significant differences in major outcomes.