ROLE OF SYNTAX SCORE AND EURO SCORE ON THE OUTCOME OF EGYPTIAN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTS.

Background: Coronary heart disease (CHD) is a major cause of death and disability in developed countries, surgical revascularization of coronary stenosis with coronary artery bypass grafting is ideal for certain patients, despite technological advancements, open-heart operations still carry a risk of mortality and morbidity. To aid in the selection of patients for cardiac surgery, several risk scoring systems have been developed during the last decades. Risk models are used for two main reasons. The first is that a risk model such as Euro SCORE allows the calculation of the risk of death, The SYNTAX score is used to evaluate coronary artery complexity and is well correlated with early and long-term outcomes after CABG. Objective: Identify accuracy of SYNTAX score Vs EURO score in prediction of mortality and morbidity of CABG patients in Egyptian population Patients and Methods: prospective observational study, done at the National Heart Institute of Egypt, Amiri hospital and Adan hospital in Kuwait in the period from July 2016 till December 2017. We collected demographic data, preoperative, operative, and postoperative data. Inclusion criteria: age: from 30-80, isolated CABG without other cardiac diseases, elective cases .Exclusion criteria: emergency cases, combined ischemic and valvular cases even significant ischemic Mitral regurge and redo cases. The sheet included preoperative data regarding age , sex , weight ,DM , HTN , COPD , Liver cell failure, renal cell failure , previous hospital admission , pre and post-operative echo data , history of bleeding , history of blood transfusion , monitoring the pre and post hospital complications and also history of drug administration like ASA. The surgical procedures were performed according to the Institute and hospitals protocol. Postoperative data including hospital, ICU stay, chest tubes drainage, blood products transfusion, re-exploration for bleeding and surgical site infection and any other undesired events. Results: 70 males with age ranges between 40 and 72 years. 55 smokers, 42 diabetic on insulin 20 COPD, 10 chronic renal impairment, 5 previous CVA, 45 have dyslipidemia, same number hypertensive. Operative and postoperative: 10 patients needed IABP, 5 had heart failure, 5 had postoperative MI, 5 reopened for re-exploration, 10 have superficial wound infect, 20 patients of them have postoperative arrhythmias while mortality was 5 %. Conclusion: The study approved that both EURO SCORE II and SYNTAX SCORE II are accurate in the prediction of the outcome of CABG and prediction of high risk patients and is more liable for detection of morbidity and mortality and complications, however EURO score is more accurate.New score combining anatomical variant as SYNTAX score plus pathophysiological score as euro score will probably carry higher specificity and sensitivity.