Concomitant CABG vs. CABG Alone - A Comparative Analysis of Early Outcomes

Abstract

Concomitant CABG is performed in combination with other cardiac procedures (VHD, CHD) while CABG is performed exclusively for CAD. Objective: To compare the mortality and perioperative outcomes between CABG and concomitant CABG for proper quoting of risk & optimizing the treatment decision for improved patient outcomes. Methods: The observational study on retrospective data was conducted at Rehman Medical Institute from December 2020 to December 2022. A total of 169 patients were included, with 89 in the CABG and 80 in the concomitant CABG group.  Ethical approval was granted and inclusion criteria were met. Data were analyzed using SPSS 25. Results: A total of 169 patients were included with a mean age of 57.72±10.65 & the majority of the male population (77.5%). Most of the patients had NYHA III (56.1%) & CCS III (43.9%) class symptoms. Hypertension was our most common co-morbidity (58.0%), followed by dyslipidemia (52.3%) & DM (47.3%).  Concomitant CABG has the worst parameters in terms of intraoperative characteristics such as a statistically significant higher rate of intraoperative transfusion (p <0.001), prolonged perfusion (p <0.001) & cross-clamp time (p<0.001). Similarly, concomitant CABG patients have the worst postoperative outcomes with a significantly higher incidence of mortality (p <0.001), post-operative transfusion requirement (p 0.008), increased duration of mechanical ventilation hours (p 0.005), extended hours of ICU stay (p 0.02) & higher rates of re-intubation (p 0.03). Conclusions:  Concomitant CABG is no doubt a high-risk procedure as signified by its worst outcomes.