Total arterial coronary revascularization and factors influencing in-hospital mortality

Objective: To determine if arterial conduit selection or more efficient art erial revascularization techniques influence in-hospital mortality. Methods : Data from patients undergoing coronary artery bypass surgery at Royal Mel bourne Hospital, Australia, between 1 January 1996 and 30 June 1998 (n = 16 81) was collected prospectively. Logistic regression analysis was performed . Results: Independent preoperative predictors of increased in-hospital mor tality included renal failure, redo coronary artery surgery and intra-aorti c balloon pump use. In-hospital mortality for total arterial revascularizat ion 0.7%, radial artery use 0.9%, pedicled arterial revascularization 0.2%, composite arterial conduit 0.4%, and the exclusive Y graft operation 0.3%. These were all associated with reduced in-hospital mortality. Mortality wh en vein graft was used was 2.9%. Most patients received total arterial reva scularization, which was considered the primary surgical strategy. Conclusi on: Total arterial revascularization, radial artery use and complex arteria l reconstructions were associated with reduced in-hospital mortality. Preop erative renal failure, intra-aortic balloon pump use and redo coronary surg ery predicted greater in-hospital mortality. (C) 1999 Elsevier Science B.V. All rights reserved.