ประสิทธิผลของการผ่าตัดบายพาสเส้นเลือดหัวใจในโรงพยาบาลสมุทรสาคร

Nuttapong Ruaman

Authors

Nuttapong Ruaman Samut Sakhon Hospital

Keywords:

coronary artery bypass surgery, primary percutaneous coronary intervention, left main lesion

Abstract

Objective: To evaluate the effectiveness and outcomes of coronary artery bypass grafting (CABG) in patients with coronary artery disease at Samutsakhon Hospital.

Method: This retrospective descriptive study included 279 patients who underwent CABG. Patients were categorized into two groups: 101 with left main (LM) coronary lesions and 178 without LM lesions. Data were collected from the Department of Cardiothoracic Surgery, Samutsakhon Hospital. Statistical analyses included descriptive statistics and chi-square test.

Results: The mean patient age was 64.18 ± 8.85 years. The most common comorbidities were hypertension (67.7%), hyperlipidemia (49.8%), and diabetes mellitus (49.5%). Hypertension was significantly less frequent in the LM group (p = .005). The most common clinical presentation was non-ST-elevation myocardial infarction (NSTEMI), accounting for 85.3% of cases. A history of prior percutaneous coronary intervention was found in 11.8% of patients, most commonly involving the left anterior descending artery (LAD). The mean left ventricular ejection fraction (LVEF) was 43.01 ± 12.64%. The overall postoperative mortality rate was 7.2%. Postoperative complications included arrhythmia (8.6%), acute kidney injury (2.15%), and stroke (0.72%). The use of intra-aortic balloon pump (IABP) was significantly more common in the LM group (p = 0.034), which also demonstrated a lower mean LVEF.

Conclusion: CABG is a safe procedure with low postoperative mortality and complication rates. Careful preoperative assessment, individualized surgical planning, and appropriate conduit selection according to lesion characteristics contribute to improved patient outcomes.

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