Quality of life in patients after minimally invasive endoscopic atraumatic coronary artery bypass grafting: a long-term follow-up.

BACKGROUND Quality of life (QoL) is an acknowledged parameter that subjectively describes treatment effectiveness and is used also in cardiac surgery. Minimally-invasive totally endoscopic atraumatic coronary artery bypass grafting (EACAB) does not require the use of cardiopulmonary bypass, reduces hospital stay and facilitates early rehabilitation. Therefore, this procedure should significantly improve QoL in patients with coronary artery disease. AIM To assess QoL during a 12-year follow-up in patients who underwent EACAB. METHODS The study group comprised 706 consecutive patients who underwent EACAB between April 1998 and December 2010. Median duration of follow-up was 1918 days. QoL was assessed by either telephone interview or letter correspondence. Complete data were obtained from 413 persons aged 59 ± 6 years. We evaluated the effect of pre- and postoperative variables on QoL. RESULTS Compared with the preoperative period, a marked improvement in QoL after EACAB was reported by 38.6%, and improvement by 37.2% of patients. No change in QoL was noted by 18.8% of subjects, and 5.4% of responders reported deterioration of QoL. The following parameters were found to have no impact on QoL: gender (p = 0.3), myocardial infarction (MI) before EACAB (p = 0.3), diabetes mellitus (p = 0.7), and baseline angina severity by the Canadian Cardiovascular Society (CCS) classification (p = 0.8). Time delay between the surgery and QoL assessment had no impact on the results. During the follow-up, reported QoL was related to the severity of angina symptoms (p = 0.006), need for rehospitalisation (p = 0.02), MI (p = 0.04) and repeated revascularisation (p = 0.02). In multivariate analysis, only MI had a significant impact on QoL (p = 0.04). Current drug therapy had no impact on QoL. CONCLUSIONS EACAB significantly improved QoL in coronary patients. MI during follow-up was associated with deterioration of QoL.