Long-term Outcomes After Reoperative Coronary Artery Bypass Grafting

Bianco, Valentino; Kilic, Arman; Gleason, Thomas G.; Aranda‐Michel, Edgar; Habertheuer, Andreas; Humar, Rishab; Wang, Yisi; Navid, Forozan; Sultan, Ibrahim

doi:10.1016/j.athoracsur.2020.04.092

Cited by 4 publications

(4 citation statements)

References 33 publications

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“…Considering the high recurrence frequency of atherosclerosis, one strategy to reduce the time-limiting factor of TEVGs in the case of disease-recurrent patients could be their initiation at the time of the first therapeutic intervention, immediately after the recurrence of the vascular obstruction, as a preventive measure. Moreover, a second surgical intervention may increase post-operatory complications and significantly reduce patient quality of life ( Bianco et al, 2021 ). Considering the period between the application of the by-pass and noticeable reactions to it in the patient as a crucial clinical determinant, it seems reasonable to remark upon the importance of understanding the biological nature of atherosclerotic plaque formation.…”

Section: Tissue-engineered Vascular Graftsmentioning

confidence: 99%

Clinical implications of inflammation in atheroma formation and novel therapies in cardiovascular diseases

Barungi

Hernández-Camarero²,

Moreno-Terribas³

et al. 2023

Front. Cell Dev. Biol.

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Cardiovascular diseases (CVD) are the leading causes of death and disability in the world. Among all CVD, the most common is coronary artery disease (CAD). CAD results from the complications promoted by atherosclerosis, which is characterized by the accumulation of atherosclerotic plaques that limit and block the blood flow of the arteries involved in heart oxygenation. Atherosclerotic disease is usually treated by stents implantation and angioplasty, but these surgical interventions also favour thrombosis and restenosis which often lead to device failure. Hence, efficient and long-lasting therapeutic options that are easily accessible to patients are in high demand. Advanced technologies including nanotechnology or vascular tissue engineering may provide promising solutions for CVD. Moreover, advances in the understanding of the biological processes underlying atherosclerosis can lead to a significant improvement in the management of CVD and even to the development of novel efficient drugs. To note, over the last years, the observation that inflammation leads to atherosclerosis has gained interest providing a link between atheroma formation and oncogenesis. Here, we have focused on the description of the available therapy for atherosclerosis, including surgical treatment and experimental treatment, the mechanisms of atheroma formation, and possible novel therapeutic candidates such as the use of anti-inflammatory treatments to reduce CVD.

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Section: Tissue-engineered Vascular Graftsmentioning

confidence: 99%

Clinical implications of inflammation in atheroma formation and novel therapies in cardiovascular diseases

Barungi

Hernández-Camarero²,

Moreno-Terribas³

et al. 2023

Front. Cell Dev. Biol.

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“…With advancements in surgical techniques and increased experience, isolated CABG procedures have low operative 7,19,20 and long-term mortality. 5,7,[21][22][23] Compared with single internal mammary use, BIMA use has similar complication rates and mortality 24,25 or improved mortality based on the literature. 26,27 Di Mauro et al 28 found no mortality difference between in situ and Y-graft RIMA during a BIMA CABG.…”

Section: Commentmentioning

confidence: 99%

“…As myocardial surgical revascularization procedures continue to be performed on a population with an increasing life expectancy, it is imperative to analyze how multiarterial grafting specifically with RIMA use affects outcomes. With advancements in surgical techniques and increased experience, isolated CABG procedures have low operative 7,19,20 and long‐term mortality 5,7,21–23 . Compared with single internal mammary use, BIMA use has similar complication rates and mortality 24,25 or improved mortality based on the literature 26,27 .…”

Section: Commentmentioning

confidence: 99%

The use of free versus in situ right internal mammary artery in coronary artery bypass grafting

Aranda‐Michel

Serna‐Gallegos

Navid

et al. 2021

Journal of Cardiac Surgery

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Introduction: Coronary artery bypass grafting (CABG) continues to be the most commonly performed cardiac surgical procedure in the world. The use of multiarterial grafting may confer a long-term survival benefit over the use of vein grafts. However, there is a paucity of data comparing the use of in situ versus free right internal mammary artery (RIMA) in isolated CABG. Methods: Patients that underwent isolated CABG between 2010 and 2018 where RIMA was used in addition to a left internal mammary artery graft. Patients with prior cardiac surgery or percutaneous coronary intervention were excluded. Propensity matching was used for subanalysis. Mortality and major adverse cardiac and cerebrovascular events (MACCE) were analyzed with Kaplan-Meier survival curves and Cox multivariable regression. Heart failure-specific readmissions were assessed with cumulative incidence curves with Fine and Gray competing risk regression.Results: A total of 667 patients underwent isolated CABG. Of those, 422 had free RIMA and 245 had in situ RIMA utilized. Mortality was similar between cohorts (p = 0.199) with 5-year mortality rates of 6.6% (free) and 4.1% (in situ). MACCE was similar between cohorts, with 5-year event rates of 33.6% and 33.9% (p = 0.99).RIMA style was not a significant predictor of any outcome. Conclusion:There was no difference in long-term mortality, complications, MACCE, or heart failure readmissions when comparing a contemporary cohort of patients undergoing isolated CABG utilizing RIMA as a conduit. These data may allow surgeons to consider using RIMA either as an in situ or a free conduit.

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“…2,3 Over the last decade, the operative risks associated with previous heart operation have persisted as the risk profile of those undergoing reoperation has increased. 4,5 In this edition of the Journal, the group from Baylor draws upon their vast experience to quantitate the impact of previous CABG on proximal aortic surgery. 6 They compare a group with previous CABG who underwent proximal aortic surgery with a propensity-matched group undergoing proximal aortic surgery without previous CABG.…”

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confidence: 99%