Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jan 9, 2021; 10(1): 12-21
Published online Jan 9, 2021. doi: 10.5492/wjccm.v10.i1.12
Intensive care outcome of left main stem disease surgery: A single center three years’ experience
Amr S Omar, Samy Hanoura, Yasser Shouman, Praveen C Sivadasan, Suraj Sudarsanan, Hany Osman, Abdul Rasheed Pattath, Rajvir Singh, Abdulaziz AlKhulaifi
Amr S Omar, Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Unit, Hamad Medical Corporation, Doha 3050, DA, Qatar
Amr S Omar, Department of Medicine, Weill Cornell Medical College in Qatar, Doha 3050, DA, Qatar
Amr S Omar, Department of Critical Care Medicine, Beni Suef University, Beni Suef 62511, Egypt
Samy Hanoura, Yasser Shouman, Suraj Sudarsanan, Hany Osman, Abdul Rasheed Pattath, Abdulaziz AlKhulaifi, Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
Samy Hanoura, Hany Osman, Department of Anesthesia, Alazhar University, Cairo 11651, Egypt
Praveen C Sivadasan, Department of Cardiothoracic Surgery/Intensive Care Unit Section, Hamad Medical Corporation, Doha 3050, DA, Qatar
Rajvir Singh, Department of Medical Research, Hamad Medical Corporation, Doha 3050, DA, Qatar
Abdulaziz AlKhulaifi, Department of Cardiothoracic Surgery, Qatar University, Doha 3050, DA, Qatar
Author contributions: Omar AS contributed to study design, concept, writing the manuscript and revising the final form; Hanoura S contributed to data collection and manuscript revision; Shouman Y contributed to writing and discussion management; Sivadasan PC contributed to data management and manuscript revision, data collection, interpretation of data, and revising of the manuscript; Sudarsanan S contributed to data collection and revision; Osman H contributed to data collection; Pattath AR contributed to critical revision; Singh R contributed to statistical analysis; AlKhulaifi A suggested the idea, as a chair of the department provided general support and substantial contribution to concept and design, acquisition of data; all authors read and approved the final manuscript.
Supported by Hamad Medical Corporation, No. MRC-01-17-058.
Institutional review board statement: The IRB board in Hamad medical corporation approved this research and waived consent as it was a retrospective study.
Informed consent statement: The studied group as the study was retrospective in nature and no specific intervention was described by the author’s methodology. The medical research centre waived the informed consent for the project.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interest.
Data sharing statement: The authors agree to share data if it is permissive by their institution.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amr S Omar, MBChB, MD, PhD, Professor, Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Unit, Hamad Medical Corporation, 1st Floor, CTICU, Heart Hospital Hamad Medical Corporation, Doha 3050, DA, Qatar. a_s_omar@yahoo.com
Received: October 11, 2020
Peer-review started: October 11, 2020
First decision: December 1, 2020
Revised: December 9, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: January 9, 2021
Processing time: 87 Days and 3.8 Hours
ARTICLE HIGHLIGHTS
Research background

Left main coronary artery (LMCA) supplies more than 80% of the left ventricle, and significant disease of this artery carries a high mortality unless intervened surgically. However, the influence of coronary artery bypass grafting (CABG) surgery on patients with LMCA disease on morbidity intensive care unit (ICU) outcomes needs to be explored.

Research motivation

However, the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring.

Research objectives

We aim at determining whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome.

Research methods

Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG. Patients were divided into 2 groups; those with LMCA disease as group 1 (75 patients) and those without LMCA disease as group 2 (324 patients). We correlated ICU outcome parameters including ICU length of stay, post-operative atrial fibrillation, acute kidney injury, re-exploration, perioperative myocardial infarction, post-operative bleeding in both groups.

Research results

In this study, patients with LMCA disease had a significantly higher prevalence of diabetes (43.3% vs 29%, P = 0.001). However, we did not find a statistically significant difference with regards to ICU stay, or other morbidity and mortality outcome measures.

Research conclusions

Patients with left main stem (LMS) disease showed similar outcome as those without LMS in this study. Diabetes was more prevalent in patients with LMS. We observed that patients with LMS had significantly more intra-aortic balloon pump (IABP) utilization. These findings may help in guiding decision making for future practice and stratifying the patients’ care.

Research perspectives

(1) The hospital length of stay did not differ between the studied groups with and without LMS disease; (2) The secondary outcome measures did not show any significant differences among the studied population; (3) Need for IABP support for LMS group was significantly higher than the group without LMS; and (4) Diabetes was more prevalent in patients with LMS.