Off-pump coronary artery bypass grafting for poorly controlled diabetic patients.

OBJECTIVE

To estimate the postoperative outcome of off-pump coronary artery bypass grafting (OPCAB) for patients with poorly controlled diabetes mellitus as evaluated by preoperative hemoglobin A1c (HbA1c).

PATIENTS AND

METHODS

The preoperative value of HbA1c in 101 diabetic patients who had undergone OPCAB from January 2000 to January 2007 was reviewed. A value of 6.5% was used as an indicator of poorly controlled hyperglycemia, and patients were distributed into a well-controlled group (group A: HbA1c <6.5, n = 47) or a poorly controlled group (group B: HbA1c >6.5, n = 54). The average follow-up period was 2.2 +/- 1.3 years.

RESULTS

There was no difference in the number of anastomoses (group A: 2.76 +/- 1.00 vs. group B: 2.63 +/- 0.80; p = 0.45) or the use of bilateral internal thoracic arteries (78.7% vs. 81.4%; p = 0.80). Postoperative angiography was carried out in 97 patients. The graft patency rate was 96.9% (126/130) in group A and 99.2% (131/132) in group B (p = 0.37). The stenosis free rate was 92.3% (120/130) in group A and 93.1% (123/132) in group B (p = 0.82). There were no operative deaths, no hospital deaths, and no late cardiac deaths. Postoperative atrial fibrillation occurred in 14 patients (29.7%) of group A and 12 (22.2%) of group B (p = 0.49). Wound dehiscence occurred in 2 patients (4.3%) of group A and 5 (9.3%) of group B (p = 0.44). Postoperative hospital stay lasted 22.1 +/- 9.5 days in group A and 21.7 +/- 9.1 days in group B (p = 0.86).

CONCLUSIONS

OPCAB is feasible in patients having poorly controlled diabetes mellitus, and their condition does not compromise the surgical outcome.