Long-term follow-up of total arterial versus conventional and hybrid myocardial revascularization: A propensity score matched analysis

Bacco, Lorenzo Di; Repossini, Alberto; Tespili, Maurizio; Muneretto, Claudio; Bisleri, Gianluigi

doi:10.1016/j.carrev.2018.04.006

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…Hence, which comorbidities were present preoperatively that could have caused all-cause mortality postoperatively, are unknown. Cardiovascular death occurred in 5 of 18 deaths, which is similar to what has been previously described by Repossini et al and is slightly lower than described by Di Bacco et al 22,27 We reported a iCVA rate of 2.5% and a TIA rate of 1.7% at long-term follow-up. Kiaii et al reported in 2008 clinical outcomes of the first 58 HCR patients in our cohort of patients and showed a postoperative CVA rate of 2%.…”

Section: Discussionsupporting

confidence: 90%

“…5 Other, small, cohort studies reported similar MACCE at mid- and long-term follow-up (3 to 6 years). 22 -24 The occurrence of increased MACCE in those with diabetes and higher SYNTAX Score emphasize the particular utility of HCR in patients with more focal and less complex multivessel disease, particularly as it applies to the arteries targeted for PCI. 25 At follow-up 15% of our patients ( n = 18) had died.…”

Section: Discussionmentioning

confidence: 99%

“…Tajstra et al reported an all-cause mortality of 6.4%, but 2 cohort studies by Di Bacco et al and Holzhey et al reported 13.5% and 15.2% all-cause mortality, respectively. 22,26 All studies have had a small sample size (89 to 107) and were conducted in a selected group of patients, giving rise to selection bias and in part explaining the difference in rates. Also, no comorbidities such as malignancies were described.…”

Section: Discussionmentioning

confidence: 99%

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Five-Year Outcomes After Hybrid Coronary Revascularization: A Single Center Experience

Jong

Jacob

Jalali

et al. 2021

Innovations�(Phila)

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Objective Hybrid coronary revascularization (HCR) combines both surgical and percutaneous coronary revascularization procedures. It offers a minimally invasive strategy for multivessel coronary artery disease and combines the advantages of both. However, quantitative long-term patency and clinical outcomes remain understudied. The objective of this study was to assess clinical outcomes and graft and stent patency at 5-year follow-up. Methods From January 2004 to January 2015, 120 patients were enrolled in this study. They underwent robotically assisted minimally invasive coronary artery bypass grafting of left internal thoracic artery (LITA) to the left descending artery (LAD) and percutaneous coronary intervention of non-LAD vessels. Primary outcome was graft (LITA-LAD) patency determined at 5 years of follow-up, assessed by computed tomography angiography and rest and stress myocardial perfusion scintigraphy (MPS-MIBI). Secondary outcomes were stent patency and major adverse major cardiac and cerebrovascular events (MACCE). Also, freedom from recurrence of angina was assessed. Results At follow-up, 18 of 120 patients (15%) had died (in 5 patients the cause of death was cardiovascular). Among survivors, follow-up was achieved in 83 of 102 (81%). In 76 of 83 patients (92%) there was a patent LITA-LAD graft and in 75 of 83 (90%) a patent stent was demonstrated. MACCE occurred in 36 of 120 patients (30%). Freedom from recurrence of angina occurred in 92 of 120 patients (77%). Conclusions HCR is a safe and a promising procedure. It provides a minimally invasive approach and results in complete revascularization with good 5-year patency and clinical outcomes.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Five-Year Outcomes After Hybrid Coronary Revascularization: A Single Center Experience

Jong

Jacob

Jalali

et al. 2021

Innovations�(Phila)

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“…In total, 14 studies (12 observational studies and 2 RCTs), consisting of 4226 patients were included in this systematic review 28–41 . Out of these, 1649 patients underwent HCR and 2617 were managed with traditional CABG procedure.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 14 studies (12 observational studies and 2 RCTs), consisting of 4226 patients were included in this systematic review. [28][29][30][31][32][33][34][35][36][37][38][39][40][41] Out of these, 1649 patients underwent HCR and 2617 were managed with traditional CABG procedure. A summary of study characteristics delineating HCR and CABG groups is detailed in Table 1.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

Nagraj

Tzoumas

Kakargias

et al. 2022

Cathet Cardio Intervent

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Objectives To compare the outcomes of hybrid coronary revascularization (HCR) with traditional coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD). Background HCR has emerged as an alternative to CABG in patients with MVCAD. Through minimally invasive surgical techniques, HCR carries the potential for faster recovery postoperatively, fewer complications, and lower utilization of resources. Methods Systematic search of electronic databases was conducted up to December 2021 and studies comparing HCR with CABG in the treatment of MVCAD were included in this meta‐analysis. Primary outcomes of interest were incidence of 5‐year mortality and major adverse cardiac and cerebral event (MACCE). Results Fourteen studies (12 observational studies and 2 randomized controlled trials) comprising 4226 patients were included. The rates of 5‐year mortality (odds ratios [OR]: 1.55; 95% confidence interval [CI]: 0.92−2.62; I2 = 83.0%) and long‐term MACCE (OR: 0.97; 95% CI: 0.47−2.01; I2 = 74.7%) were comparable between HCR and CABG groups. HCR was associated with a significantly lower likelihood of perioperative blood transfusion (OR: 0.36; 95% CI: 0.25−0.51; I2 = 55.9%), shorter mean hospital stay (weighted mean difference: −2.04; 95% CI: −2.60 to −1.47; I2 = 54%), and risk of postoperative acute kidney injury (OR: 0.45; 95% CI: 0.23−0.88; p = 0.02). CABG demonstrated a lower likelihood of requiring long‐term repeat revascularization (OR: 1.51; 95% CI: 1.03−2.20; I2 = 18%) over a follow‐up duration of 29.14 ± 21.75 months. Conclusion This meta‐analysis suggests that HCR is feasible and safe for the treatment of MVCAD. However, benefits of HCR should be carefully weighed against the increased long‐term risk of repeat‐revascularization when selecting patients, and further studies evaluating differences in long‐term mortality between HCR and CABG are required.

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Off-pump coronary artery bypass grafting: Exposure, stabilization, and strategy

Calafiore¹,

Angelini

Mauro

et al. 2021

Technical Aspects of Modern Coronary Artery Bypass Surgery

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Long-term follow-up of total arterial versus conventional and hybrid myocardial revascularization: A propensity score matched analysis

Cited by 8 publications

References 25 publications

Five-Year Outcomes After Hybrid Coronary Revascularization: A Single Center Experience

Five-Year Outcomes After Hybrid Coronary Revascularization: A Single Center Experience

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

Off-pump coronary artery bypass grafting: Exposure, stabilization, and strategy

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