Comparing short and long term survival of patients undergoing off pump coronary artery bypass graft with and without coronary endarterectomy

Sabzi, Feridoun; Asadmobini, Atefeh; Rezaei, Mansour

doi:10.1016/j.ihj.2017.02.008

Cited by 5 publications

(12 citation statements)

References 29 publications

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“…Therefore, a total of 12 studies including 114,319 patients undergoing CABG were included in our study. [7][8][9][10][11][12][13][14][15][16][17][18] All studies were observational epidemiological studies, 2 of the 12 included studies were multicenter studies, 9,18 and three of the included studies used propensity score matching method. 12,15,18 Of these, 12 provided data for 30days mortality; 11 [7][8][9][10][11][12][13][14][16][17][18] investigated the incidence of postoperative myocardial infraction; 8 7,8,[10][11][12][13][14]17 reported the rate of low output syndrome; 8 [7][8][9][10][11][12][13][14] reported the incidence of cardiac arrhythmia; 5 8,9,12,…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…7–18 All studies were observational epidemiological studies, 2 of the 12 included studies were multicenter studies, 9,18 and three of the included studies used propensity score matching method. 12,15,18 Of these, 12 provided data for 30-days mortality; 11 7–14,16–18 investigated the incidence of postoperative myocardial infraction; 8 7,8,10–14,17 reported the rate of low output syndrome; 8 7–14 reported the incidence of cardiac arrhythmia; 5 8,9,12,17,18 provided the data for renal dysfunction; and 5 7,8,11,14,15 reported 5 years survival. Most of the patients received dual antiplatelet therapy or anticoagulation combined with antiplatelet therapy.…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Zhang

2022

Perfusion

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Objective: The aim of this systematic review and meta-analysis was to evaluate the short-term and long-term outcomes of coronary artery bypass grafting (CABG) with coronary endarterectomy (CE) versus isolated CABG. Methods: Studies evaluating outcomes of CABG with CE (CE-CABG) were searched from 1 January 2000 to 30 September 2022, on PubMed, Embase, and Cochrane databases. The primary outcome was 30 -days mortality. Secondary outcomes were postoperative myocardial infraction, low output syndrome, cardiac arrhythmia, renal dysfunction, and 5 years survival. Results: A total of 12 observational studies including 114,319 patients assessing CE-CABG ( n = 35,174) versus isolated CABG ( n = 79,145) were included. Compared to isolated CABG alone, CE-CABG was significantly associated with increased incidences of 30-days mortality (RR, 1.87; 95% CI, 1.73–2.07; p < 0.01), postoperative myocardial infraction (RR, 1.61; 95% CI, 1.26–2.05; p < 0.01), low output syndrome (RR, 1.54; 95% CI, 1.17–2.02; p < 0.01), and renal dysfunction (RR, 1.56; 95% CI, 1.44–1.69; p < 0.01). However, there was no difference in either rate of cardiac arrhythmia (RR, 1.06; 95% CI, 0.97–1.15; p = 0.20) or 5 years survival (RR, 1.05; 95% CI, 0.95–1.16; p = 0.34) between the CE-CABG group and the control group. Subgroup analysis on CE technique showed that CE-CABG was also associated with 30 days mortality in patients undergoing closed CE (RR, 1.49; 95% CI, 1.09–2.03), whereas this association between CE and 30 days mortality was not observed in patients undergoing open CE (RR, 1.76; 95% CI, 0.58–5.32). Conclusions: Despite poor short-term outcomes, CE-CABG appeared to offer satisfactory long-term survival in patients with diffuse coronary artery disease.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Zhang

2022

Perfusion

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“…Despite the high postoperative morbidity and mortality reported in some publications [7][8], short-term morbidity and mortality are not increased in recent articles [1-3, 5-6, 9]. In recent years, severe and diffuse coronary artery disease has been associated with an increased incidence of concomitant diseases that affect the quality of life and mortality of patients [10,11]. CE with CABG is a good surgical alternative for these patients [1,[10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…With the closed technique, the ischemia time and duration of anastomosis are shorter than with the open CE technique. If the coronary stenosis is due to in-stent restenosis, CE is more favorable because the plaque is removed along with the stenosed stent [11]. CE with patch angioplasty has a long survival, and the need for a new intervention is signi cantly reduced [14].…”

Section: Introductionmentioning

confidence: 99%

Experiences of the Coronary Endarterectomy with Closed Technique in Coronary Artery Bypass Surgery

Ertürk,

Reyhanoğlu,

Özcan

et al. 2023

Preprint

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Background Coronary artery bypass grafting (CABG) with coronary artery endarterectomy (CE) is a necessary and effective alternative procedure for complete vascularization in diffuse and severe coronary artery disease. The mid- to long-term outcomes of CE remain highly controversial. The aim of this study is to compare the results of closed-technique CABG CE with those of other recently published articles. Methods In this prospective study, 6000 patients underwent standard coronary artery bypass grafting between August 2004 and August 2014. Approximately 3.2% of these patients, or a total of 193 patients, underwent CE as part of this surgery. A closed-technique was performed in all patients who underwent CE. Results The perioperative myocardial infarction and postoperative morbidity of patients who underwent the closed-technique CE remained unchanged; however, the mortality rate of these patients compared with the open technique CE was lower than that reported in the current literature. In addition, the closed- technique is a highly advantageous technique. It is considered an overall safe procedure because the anastomosis time is short and minimal cross-clamp time when compared with the open technique CE. Conclusion The closed-technique CE should be considered an adequate, safe surgical procedure and a good alternative choice for complete revascularization in suitable patients. Furthermore, the closed-technique CE is a safe operation for the patient with excellent survival rates and graft patency rates. In a select group of patients, perioperative and postoperative mortality and morbidity are not high when the procedure is performed by an experienced team of OR.

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“…Coronary artery bypass grafting (CABG) and coronary endarterectomy (CE) have been the established surgical strategy for myocardial revascularization of diffuse coronary artery disease [ 1 – 3 ]. However, postoperative acute myocardial infarction (AMI) secondary to acute thrombosis of the endarterectomized artery is a life-threatening complication after CABG+CE despite of advancing in surgical techniques and aggressive antithrombotic therapy [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative intra-aortic balloon pump improves 30-day outcomes of patients undergoing extensive coronary endarterectomy

Liu

Fang

et al. 2020

J Cardiothorac Surg

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Background The efficacy of intra-aortic balloon pump (IABP) has been proven in high-risk patients undergoing coronary artery bypass grafting (CABG). However, data on the timing and benefits of IABP support in diffuse coronary artery disease after CABG combined with coronary endarterectomy (CE) remain scarce. This retrospective study assessed the effect of intraoperative or postoperative IABP on 30-day outcomes of off-pump CABG+CE. Methods From January 2012 to December 2018, 546 patients undergone off-pump CABG+CE were divided into control group ( n = 437) and IABP group ( n = 109). Risk factors for 30-day outcomes were evaluated. Subgroup analysis from IABP group was conducted to identify the effect of timing IABP on 30-day outcomes. Results CE on left anterior descending branch of coronary artery (LAD) (OR = 3.079, 95% CI 1.077–8.805, P = 0.036), CE with≥2 vessels (OR = 9.123, 95% CI 3.179–26.033, P < 0.001) and length of atherosclerotic plaque ≥3 cm (OR = 16.017, 95% CI 5.941–43.183, P < 0.001) were independent risk factors for postoperative acute myocardial infarction (AMI) and 30-day mortality. Comparing with intraoperative IABP support, postoperative IABP support (OR = 3.987, 95% CI1.194–13.317, P = 0.025) was closely associated with postoperative AMI and 30-day mortality. Conclusions For patients undergone off-pump CABG and extensive CE (CE on LAD, CE ≥2 vessels and length of atherosclerotic plaque ≥3 cm), intraoperative IABP support may improve 30-day outcomes.

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Comparing short and long term survival of patients undergoing off pump coronary artery bypass graft with and without coronary endarterectomy

Cited by 5 publications

References 29 publications

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Outcomes of coronary artery bypass grafting with coronary endarterectomy: A systematic review and meta-analysis of recent studies

Experiences of the Coronary Endarterectomy with Closed Technique in Coronary Artery Bypass Surgery

Intraoperative intra-aortic balloon pump improves 30-day outcomes of patients undergoing extensive coronary endarterectomy

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