Analysis of Myocardial Ischemia Parameters after Coronary Artery Bypass Grafting with Minimal Extracorporeal Circulation and a Novel Microplegia versus Off-Pump Coronary Artery Bypass Grafting

Koechlin, Luca; Zenklusen, Urs; Doebele, Thomas; Rrahmani, Bejtush; Gahl, Brigitta; Schaeffer, Thibault; Berdajs, Denis; Eckstein, Friedrich S.; Reuthebuch, Oliver

doi:10.1155/2020/5141503

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…CAD is a common cardiovascular disease, and CABG is an important treatment method for surgical revascularization to restore cardiac blood perfusion [ 12 ]. The influence of BMI on the outcome of patients undergoing CABG surgery is still highly controversial.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Obesity on Mortality Following Coronary Artery Bypass Graft Surgery: A Retrospective Study from a Single Center in China

Gao

Liu

et al. 2021

Med Sci Monit

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Background Coronary artery bypass graft (CABG) surgery has become a routine surgical procedure for patients with occlusive coronary artery atherosclerosis. Worldwide, increasing levels of obesity are associated with ischemic heart disease and systemic comorbidities. This retrospective study from a single center in China aimed to investigate the effects of obesity on patient mortality following CABG surgery. Material/Methods Patients undergoing CABG (N=1471) were grouped according to body mass index (BMI) as normal weight (N=596), overweight (N=684), or obese (N=191). Baseline clinical characteristics and outcomes were recorded. Logistic regression analysis was performed for 30-day postoperative mortality. Kaplan-Meier survival curves were plotted, and Cox regression analysis investigated risk and protective factors for long-term mortality, with subgroup analysis for differences between on-pump and off-pump CABG groups. Results The 30-day postoperative mortality was 5.0% in the normal-weight group, 1.3% in the overweight group, and 0% in the obese group. BMI was an independent protective factor for 30-day postoperative mortality (odds ratio=0.748; 95% confidence interval, 0.640–0.874; P <0.001). The 10-year mortality for the groups was 13.2% (normal), 7.8% (overweight), and 12.7% (obese). The >20-year mortality rates for the groups were 33.0% (normal), 41.5% (overweight), and 12.7% (obese). There was no significant correlation between BMI and long-term mortality. Being overweight had a protective effect against long-term mortality in the off-pump CABG subgroup. Conclusions An “obesity paradox” was identified in postoperative outcomes in patients following CABG surgery, with an increased BMI associated with reduced 30-day postoperative mortality. This association was more significant in the off-pump CABG group.

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Section: Discussionmentioning

confidence: 99%

The Effects of Obesity on Mortality Following Coronary Artery Bypass Graft Surgery: A Retrospective Study from a Single Center in China

Gao

Liu

et al. 2021

Med Sci Monit

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“…CABG is a standard therapeutic approach for surgical revascularization to restore cardiac blood circulation in patients with coronary artery disease (Koechlin et al, 2020). Obesity is a risk factor for problems following a PCI or CABG procedure (Ma et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Factors Contributing to Choosing Percutaneous Coronary Intervention Or Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease

Mirza

Abdulazeez²

2022

UOD

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Introduction: Coronary artery disease is a heart disease that is the main cause of mortality in both developed and developing nations. Management of coronary artery disease by coronary artery bypass graft surgery has significant complications for patients. In this regard, we aimed to determine factors contributing to choosing percutaneous coronary intervention or coronary artery bypass graft in patients with coronary artery disease. Methods: In this cross-sectional study, the patients who were diagnosed with coronary arteries disease who were admitted to rom Azadi Heart Canter and Vin Private Hospital Department of Cardiology in Duhok city from November 2021 to January 2022 were included. The coronary artery disease patients were of both genders aged 18 - 75 years with various socio-demographic characteristics who received percutaneous coronary intervention or coronary artery bypass graft were the target population of this study. Results: The study found that the mean age of the patients was 58.2 between 34 and 75 years old. The majority of the study sample were male (66%). The study showed that smoking, BMI, and diabetes mellitus were the only predictors of receiving coronary artery bypass graft or percutaneous coronary intervention the coronary artery disease patients. Heavy smokers were 3.9 times more likely to receive percutaneous coronary intervention compared to non-smoker patients (95% CI 1.5-10.5, P=0.00061). In addition, the obese patients were 3.1 times more likely to receive coronary artery bypass graft compared to normal-weight patients (95% CI: 1.1-8.5: P=0.0259) and overweight compared to normal-weight patients (OR: 3.6 95%CI: 1.3-10.; P=0.0173). The diabetic patients were 0.6 times (60%) less likely to receive coronary artery bypass graft compared to non-diabetic patients. Conclusions: The study showed that the patients who had diabetes mellitus and smokers were more likely to undergo the percutaneous coronary intervention. Being overweight and obese was shown to undergo the coronary artery bypass graft surgery rather than percutaneous coronary intervention

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“…49 Single-centre studies are generally underpowered to detect differences in myocardial protection with either perfusion strategy. 61 Low-volume cardioplegia is advocated as an integral part of MiECC strategy to limit hemodilution. The Bernese group evaluated the effectiveness of a low-volume solution composed of potassium, magnesium, xylitol and procaine with favorable results.…”

Section: Methodsmentioning

confidence: 99%

2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

et al. 2022

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The landmark 2016 Minimal Invasive Extracorporeal Technologies International Society (MiECTiS) position paper promoted the creation of a common language between cardiac surgeons, anesthesiologists and perfusionists which led to the development of a stable framework that paved the way for the advancement of minimal invasive perfusion and related technologies. The current expert consensus document offers an update in areas for which new evidence has emerged. In the light of published literature, modular minimal invasive extracorporeal circulation (MiECC) has been established as a safe and effective perfusion technique that increases biocompatibility and ultimately ensures perfusion safety in all adult cardiac surgical procedures, including re-operations, aortic arch and emergency surgery. Moreover, it was recognized that incorporation of MiECC strategies advances minimal invasive cardiac surgery (MICS) by combining reduced surgical trauma with minimal physiologic derangements. Minimal Invasive Extracorporeal Technologies International Society considers MiECC as a physiologically-based multidisciplinary strategy for performing cardiac surgery that is associated with significant evidence-based clinical benefit that has accrued over the years. Widespread adoption of this technology is thus strongly advocated to obtain additional healthcare benefit while advancing patient care.

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Analysis of Myocardial Ischemia Parameters after Coronary Artery Bypass Grafting with Minimal Extracorporeal Circulation and a Novel Microplegia versus Off-Pump Coronary Artery Bypass Grafting

Cited by 4 publications

References 35 publications

The Effects of Obesity on Mortality Following Coronary Artery Bypass Graft Surgery: A Retrospective Study from a Single Center in China

The Effects of Obesity on Mortality Following Coronary Artery Bypass Graft Surgery: A Retrospective Study from a Single Center in China

Factors Contributing to Choosing Percutaneous Coronary Intervention Or Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease

2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

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