Failure of patients to appear for coronary bypass surgery after a successful primary transcatheter intervention
Sumin A. N., Osokina A. V., Ivanov S. V., Barbarash O. L.
Keywords: coronary heart disease, coronary bypass surgery, treatment, transcutaneous coronary intervention
Background. The issue of how significant is waiting for elective coronary bypass (CB) surgery for patients, who have had a successful transcutaneous intervention (TCI) for ACS, has not been studied yet. Aim. To perform a comparative analysis of reasons for failure of patients to appear for the CB surgery after primary TCI or without TCI. Materials and methods. The study included 151 patients admitted for ACS between January, 2007 and December, 2010. Before admission, the patients had had emergency TCI with coronary artery (CA) stenting and had been scheduled for the second stage of myocardial revascularization, elective CB. 98 of these patients have passed the second stage of myocardial revascularization while 53 patients failed to appear for the second stage of surgical treatment for IHD. The control group consisted of 116 patients scheduled for elective CB based on results of elective coronary angiography (CAG). Using the continuous sampling method, a group of patients (n=51) was formed, who were admitted for elective CB on schedule within three weeks of the same month (March, 2011). The other part of patients (n=65) included patients who failed to appear for the surgery for various reasons (continuous sampling) between January 1, 2010 and March 31, 2011. Results. 35 % of patients, who had had TCI for ACS, failed to appear for the next CB surgery. The groups differed in rates of fear of surgery (р=0.017), repeated CA stenting during the waiting for CB (р=0.002), and exacerbation of concurrent disease (р=0.014). Conclusion. The following reasons were associated with the failure to appear for the surgery: repeated TCI for recurrent IHD exacerbation; patient’s refusal of the surgery due to feeling better or fear of surgery; and death of the patient at the outpatient stage.
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Sumin A.N., Osokina A.V., Ivanov S.V. et al. Failure of patients to appear for coronary bypass surgery after a successful primary transcatheter intervention. Russian Heart Journal. 2014;77 (3):144–150