Early and midterm outcomes of concomitant coronary artery bypass grafting for coronary artery disease in surgical repair of type A aortic dissection

• DOI: 10.21037/jtd-24-1587
• Publication Date: 2025-03-28T09:05:43Z
• Authors: Ling-Chen Huang; Yang-Xue Sun; Ze-Hua Shao; Xiang-Yang Qian; Cun-Tao Yu; Hong-Wei Guo
• Keywords: Concomitant

Type A aortic dissection (TAAD) is frequently complicated by concurrent coronary artery disease (CAD). This study aimed to evaluate the impact of concomitant bypass grafting (CABG) for CAD on short- and mid-term outcomes following TAAD surgical repair. retrospective, post-hoc analysis was conducted from June 2019 January 2024, involving 1,083 patients. Among them, 270 patients with were stratified into two groups based whether CABG performed: non-CABG groups. The inverse probability treatment weighting (IPTW) utilized adjust imbalanced characteristics. Kaplan-Meier survival employed assess all-cause midterm mortality. overall cohort experienced six operative deaths (2.22%). After IPTW adjustment, group exhibited a significantly lower incidence serious adverse events (2.5% vs. 8.3%, P=0.048) mortality (0.5% 4.6%, P=0.02) compared group. curve initially showed improvement but deteriorated later, revealing no significant difference between (log-rank P=0.58). However, higher in P=0.01). Notably, high graft occlusion observed during follow-up period (42.67% at 3 years 62.22% 4 years), especially when proximal anastomosed prosthesis (P=0.02). Concomitant lowers worsens outcomes. increased mainly due occlusion, which contributes cardiovascular cardiac dysfunction. Due negative long-term patency prognosis, anastomosis not recommended.