Repeat Coronary Artery Bypass Grafting: A Meta-Analysis of Off-Pump versus On-Pump Techniques in a Large Cohort of Patients

Tzoumas, Andreas; Giannopoulos, Stefanos; Kakargias, Fotis; Kokkinidis, Damianos G.; Giannakoulas, George; Faillace, Robert T.; Bakoyiannis, Christos; Doulamis, Ilias P.; Avgerinos, Dimitrios V.

doi:10.1016/j.hlc.2021.02.015

Cited by 6 publications

(2 citation statements)

References 63 publications

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“…It can signifcantly relieve the symptoms of chest tightness, shortness of breath, and exercise limitation caused by coronary ischemia in patients with CHD, and reduce the incidence of angina pectoris and myocardial infarction [1][2][3]. As the number of patients undergoing CABG increases year by year, some patients may even need to undergo bypass surgery to relieve their condition, which makes cardiac surgeons face severe challenges in terms of patient condition assessment and surgical risk prediction [4][5][6]. If the patient's surgical risk can be evaluated in advance, and an individualized treatment plan tailored to the patient's own can be prepared, the success rate of CABG will be greatly improved and the patient's prognosis will be improved.…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence and Big Data Technologies in the Construction of Surgical Risk Prediction Model for Patients with Coronary Artery Bypass Grafting

Tang

Wang

Shi

et al. 2023

Computational Intelligence and Neuroscience

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The objective of this work was to predict the risk of mortality rate in patients with coronary artery bypass grafting (CABG) based on the risk prediction model of CABG using artificial intelligence (AI) and big data technologies. The clinical data of 2,364 patients undergoing CABG in our hospital from January 2019 to August 2021 were collected in this work. Based on AI and big data technology, business requirement analysis, system requirement analysis, complication prediction module, big data mining technology, and model building are carried out, respectively; the successful CABG risk prediction system includes case feature analysis service, risk warning service, and case retrieval service. The commonly used precision, recall, and F1-score were adopted to evaluate the quality of the gradient-boosted tree (GBT) model. The analysis proved that the GBT model was the best in terms of precision, F1-score, and area under the receiver operating characteristic curve (ROC). According to the CABG risk prediction model, 1,382 patients had a score of <0, 463 patients had a score of 0 ≤ score ≤ 2, 252 patients had a score of 2 < score ≤ 5, and 267 patients had a score of >5, which were stratified into four groups: A, B, C, and D. The actual number of in-hospital deaths was 25, and the in-hospital mortality rate was 1.05%. The mortality rate predicted by the CABG risk prediction model was 2.67 ± 1.82% (95% confidential interval (CI) (2.87–2.98)), which was higher than the actual value. The CABG risk prediction model showed the credible results only in group B with AUC = 0.763 > 0.7. In group B, 3 patients actually died, the actual mortality rate was 0.33%, and the predicted mortality rate was 0.96 ± 0.78 (95% CI (0.82–0.87)), which overestimated the mortality rate of patients in group B. It successfully constructed a CABG risk prediction model based on the AI and big data technologies, which would overestimate the mortality of patients with intermediate risk, and it is suitable for different types of heart diseases through continuous research and development and innovation, and provides clinical guidance value.

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Section: Introductionmentioning

confidence: 99%

Artificial Intelligence and Big Data Technologies in the Construction of Surgical Risk Prediction Model for Patients with Coronary Artery Bypass Grafting

Tang

Wang

Shi

et al. 2023

Computational Intelligence and Neuroscience

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“…data on repeat revascularization, detailed on the frequency of PCI versus CABG.HCR was also associated with a lower length of hospital stay compared to CABG. This finding can be secondary to the minimally invasive operative technique of HCR avoiding median sternotomy, thereby allowing for improved pain control, faster recovery, and decreased length of hospitalization 56,57. Despite a shorter length of hospital stay, it is important to note that our study found no significant difference in the mean duration of ICU stay between the HCR and CABG groups unlike Dixon et al58 who in their metanalysis of 3399 patients found the HCR group to have a significantly shorter ICU stay without significant reduction in the overall length of hospital stay.…”

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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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Comparative Effectiveness of On-Pump Versus Off-Pump Coronary Surgical Revascularization Related to Postoperative Acute Kidney Injury

Koshy,

Tharakan,

George

et al. 2025

The American Journal of Cardiology

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Repeat Coronary Artery Bypass Grafting: A Meta-Analysis of Off-Pump versus On-Pump Techniques in a Large Cohort of Patients

Cited by 6 publications

References 63 publications

Artificial Intelligence and Big Data Technologies in the Construction of Surgical Risk Prediction Model for Patients with Coronary Artery Bypass Grafting

Artificial Intelligence and Big Data Technologies in the Construction of Surgical Risk Prediction Model for Patients with Coronary Artery Bypass Grafting

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

Comparative Effectiveness of On-Pump Versus Off-Pump Coronary Surgical Revascularization Related to Postoperative Acute Kidney Injury

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