الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Choice of the best revascularization strategy in the management of CAD should be carried out by a multidisciplinary heart team, to ensure choice of the most suitable and durable revascularization method (CABG or PCI) with focusing on the concept of complete revascularization, which leads to marked improvement of symptoms and reduction of the procedure associated mortality and morbidity.
Preoperative risk assessment is an integral part of the management of patients prepared for CABG, as the estimated surgical risk may affect the choice of the revascularization strategy. There are many valid risk scores that used for this purpose, as EuroSCORE II, STS Score and SYNTAX Scores. Both EuroSCORE II and STS scores are effective and accurate in estimation of in hospital and 30 days mortality post cardiac surgery but, sharing a common disadvantage of neglecting the anatomical complexity of the coronary arteries.
SYNTAX Score I is an anatomical scoring system, that used for assessment of the complexity of coronary arteries and estimation of long-term mortality and MACCE post PCI, SYNTAX Score II combines both SSI and 8 clinical variables, for estimation of 4 years mortality following both CABG and PCI for individual patient and gives its recommendation about the best revascularization strategy for the patient (PCI, CABG or both). The impact of these scores on the short-term results following CABG, is still unclear.
We prospectively studied 150 patients with MVD, performed elective primary isolated on pump CABG, to assess the impact of preoperative SYNTAX Scores on the short-term outcome. We followed up our patients for 90 days postoperatively (in hospital, visits and phone calls), for onset of mortality, MI, stroke, mediastinitis and need for RRT, then correlated the results obtained with the preoperatively calculated SYNTAX Scores and the preoperative clinical data.
By the end of follow up period, we found that; we had total mortality from all causes within 90 days occurred in 10 patients (6.7%), 8 of them (5.3%) were in hospital mortalities, 10 patients (6.7%) had MI, 5 patients (3.3%) had stroke, 5 patients (3.3%) had mediastinitis and 3 patients (2%) needed RRT
In our study, we found a significant impact of SSI on short term outcome, by finding a significant association between, increased preoperative SSI and total 90 days mortality, in hospital mortality, MI within 90 days follow up and mediastinitis.
We also found a prognostic value of preoperative SSII in evaluating the post CABG short-term outcome, as we found a significant association between increased preoperative SSII with in-hospital mortality and total 90 days mortality, but less powerful relation than SSI. Also we found a significant association between increases SSII and need for RRT.