scholarly journals The Influence of Diffuse Left Anterior Descending Artery Lesions on Outcomes of Coronary Artery Bypass Grafting

2020 ◽  
Vol 23 (4) ◽  
pp. E498-E506
Author(s):  
Yuan-Hsi Tseng ◽  
Chih-Chen Kao ◽  
Chien-Chao Lin ◽  
Ming-Shian Lu ◽  
Chu-Hsueh Lu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Left Anterior Descending Artery ◽  
All Cause Mortality ◽  
Diffuse Lesion

Background: Diffuse coronary lesions adversely influence the outcomes of coronary artery bypass grafting (CABG). This study aimed to investigate the influence of diffuse left anterior descending artery (LAD) lesions on the outcomes of CABG. Methods: The data of 123 patients, who received elective isolated CABG with the left internal mammary artery bypassed to the LAD from January 2011 to June 2017, were collected. According to their lesions (≥50% diameter stenoses) ≤2cm or >2cm in the middle and distal segment of LAD, the patients were classified into a No Diffuse Lesion (NDL) group (69 patients) and a Diffuse Lesion (DL) group (54 patients). The rates of in-hospital mortality, 5-year all-cause mortality, and major cardiac events (MCEs) (i.e. myocardial infarction, angina, acute heart failure, and atrial fibrillation) were analyzed. Results: According to the univariate analyses, the NDL group had fewer diffuse left circumflex artery (LCX) lesions (P = .001) and higher ventricular fibrillation (Vf) after aortic de-clamping (P = .03) than the DL group. According to the multivariate analyses, the in-hospital and 5-year all-cause mortality rates of the two groups did not significantly differ (P = .80 and P = .59). Otherwise, the DL group had a trend toward more MCEs (hazard ratio = 2.07, P = .061), but the difference clearly was insignificant after adjusting for diffuse LCX lesions and Vf after aortic de-clamping (P = .104). Conclusions: The results demonstrated that diffuse LAD lesions did not influence the risks of in-hospital mortality, 5-year all-cause mortality, or MCEs after CABG.

Resource Utilization in Off-Pump versus Conventional Coronary Artery Bypass Grafting in a Community Hospital: A Comparative Analysis Using Propensity Scoring

2011 ◽  
Vol 14 (2) ◽  
pp. 81 ◽  
Author(s):  
Scot C. Schultz ◽  
Scott Woodward ◽  
George Ebra
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Resource Use ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Conventional Coronary Artery Bypass

Background: At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) revascularization.Methods: From January 2000 through December 2008, 1003 patients underwent OPCAB grafting by a single surgeon (S.C.S.). Data were prospectively collected, entered into a Society of Thoracic Surgeons adult cardiac surgery database, and analyzed retrospectively. We used propensity-matching techniques to match this cohort to a group of 1003 patients who underwent CCAB.Results: The hospital mortality rate was lower for the OPCAB patients than for the CCAB patients: 2.0% (20/1003) versus 2.8% (28/1003). Predictors of hospital mortality for the entire cohort included age (P = .001), cardiogenic shock (P = .001), congestive heart failure (P = .019), history of myocardial infarction (P = .001), and reoperation (P = .007). The overall incidence of morbidity was lower for the OPCAB patients (reoperation for bleeding, P = .011; prolonged ventilation, P = .035; stroke, P = .045; cardiac arrest, P = .004). OPCAB patients experienced significantly reduced procedure times (P = .001), postoperative ventilation times (P = .035), post-operative lengths of stay (P = .035), and blood product use (intraoperative, P = .001; postoperative, P = .001).Conclusion: These outcomes clearly demonstrate that OPCAB is a safe and effective procedure for myocardial revascularization. This retrospective, nonrandomized observational study has shown that the patients who underwent OPCAB had reduced morbidity and mortality, as well as decreased resource use, compared with those who underwent CCAB.

Abstract 16253: Temporal Trends and Outcomes of Coronary Artery Bypass Grafting After Acute St-elevation Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ayman Elbadawi ◽  
Mohammed Elzeneini ◽  
Islam Y Elgendy ◽  
Mohamed Omer ◽  
Gbolahan O Ogunbayo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: There is paucity of data on the outcomes of coronary artery bypass grafting (CABG) among patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We queried the National Inpatient Sample database (2002-2016) for patients with STEMI who underwent CABG. We reported the trends in utilization of CABG for STEMI, and the associated in-hospital outcomes. Using multivariable analysis, we compared in-hospital outcomes in patients undergoing CABG on hospitalization day 1 vs. day 2 vs. day ≥3 , in the early (2002 to 2009) and contemporary cohorts (2012 to 2016). Results: Our analysis yielded 2,910,960 patients with STEMI, of whom 7.6% underwent CABG (9.6% in 2002 versus 3.9% in 2016, P trend <0.001). There was an increase in in-hospital mortality (5.8% in 2002 versus 7.6% in 2016, P trend <0.001) which corresponded to an increase in comorbidities burden among patients undergoing CABG. There was a rising trend in performing CABG on hospitalization day ≥ 3 corresponding to an increase in the utilization of MCS and pre-CABG PCI during the study years. CABG was more likely to be performed on admission day 1 in patients with anterior STEMI, cardiogenic shock or mechanical complications. In the early cohort, CABG on day 1 and day 2 was associated with higher in-hospital mortality, while in the contemporary cohort only CABG on day 1 was associated with higher in-hospital mortality compared with CABG on day ≥ 3. CABG on day 1 was associated with higher rate of cardiac arrest, hemorrhagic stroke, blood transfusion and cardiac tamponade in the earlier cohort, while in the more contemporary cohort it was associated with higher blood transfusion. Conclusions: There was a downtrend in performing CABG for STEMI, and an uptrend in in-hospital mortality after CABG. Patients undergoing emergent CABG on day 1 were more likely to have mechanical complications and cardiogenic shock and were associated with higher in-hospital mortality.

Minimally invasive versus conventional extracorporeal circulation circuits in patients undergoing coronary artery bypass surgery: a propensity-matched analysis

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Shekhar Saha ◽  
Sam Varghese ◽  
Mike Herr ◽  
Marcus Leistner ◽  
Christian Ulrich ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Circulation System ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Objectives: Minimally invasive extracorporeal circulation circuits provide several advantages compared to conventional extracorporeal circulation circuits. We compared the results of a minimally invasive extracorporeal circulation system with those of conventional extracorporeal circulation system, in patients undergoing isolated coronary artery bypass grafting. Methods: We identified 753 consecutive patients who underwent coronary artery bypass grafting at our centre between October 2014 and September 2016. These patients were divided into two groups: a minimally invasive extracorporeal circulation group (M, n = 229) and a conventional extracorporeal circulation group (C, n = 524). Baseline parameters, details of cardiac surgery as well as postoperative complications and outcomes were compared by means of a propensity-matched analysis of 180 matched pairs. Results: The median EuroSCORE II was 1.3%. Transfusion requirement of packed red blood cells (p = 0.002) was lower in Group M compared to conventional extracorporeal circulation systems. There were no differences in hospital mortality or in rates of adverse events between the matched groups. Total in-hospital mortality of the cohort was 1.7%. Conclusion: The use of minimally invasive extracorporeal circulation is associated with a significantly lower use of blood products after isolated coronary revascularisation. There were no differences concerning duration of surgery, complication rates and mortality between the groups. Therefore, the application of minimally invasive extracorporeal circulation systems should be considered as preferred technique in isolated coronary artery bypass grafting procedures.

Short- and Long-Term Outcomes in Octogenarian Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Compared with On-Pump Coronary Artery Bypass Grafting

2011 ◽  
Vol 6 (2) ◽  
pp. 110-115 ◽  
Author(s):  
Eric L. Sarin ◽  
Michael O. Kayatta ◽  
Patrick Kilgo ◽  
Ameesh Dara ◽  
John D. Puskas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Opcab Group ◽  
Short And Long Term

Objective Coronary artery bypass grafting (CAB) on elderly patients presenting with multivessel coronary artery disease has become routine in modern day operating rooms. The aim of our study was to compare short- and long-term outcomes in octogenarian patients undergoing off-pump CAB (OPCAB) versus on-pump CAB (ONCAB). Methods A propensity-adjusted, retrospective review of patients older than 80 years who underwent primary CAB from January 1996 to September 2008 at our institution's hospitals was performed. Nine hundred thirty-seven patients were divided into two groups: OPCAB (n = 540) or ONCAB (n = 397). A propensity score was calculated based on 29 preoperative risk factors to adjust for selection bias when comparing the groups for differences in death, stroke, myocardial infarction incidence, and their composite (major adverse cardiac events). Long-term survival status was determined by cross-referencing patient records with the Social Security Death Index. Logistic regression analysis and Cox proportional hazards analysis were used to determine group differences in short- and long-term survival, respectively, adjusted for the propensity score. Kaplan-Meier curves were fit to estimate 10-year survival. Results The mean age (OPCAB: 82.9 ± 2.8 years vs ONCAB: 82.3 ± 2.4, P = 0.003) and male sex (OPCAB: 292/540, 54.1% vs ONCAB: 220/397, 55.4%, P = 0.68) were clinically similar between groups. Although the ejection fraction (OPCAB: 52.1 ± 12.5% vs ONCAB: 50.6 ± 13.1, P = 0.10) were similar between groups, the mean number of distal anastomoses [OPCAB: 2.7 ± 1.0 (median 3) vs ONCAB: 3.4 ± 0.9 (median 3), P < 0.001] were less in the OPCAB group. The median postoperative length of stay was 7 days for OPCAB group and 6 for the ONCAB group (P = 0.31). The Society of Thoracic Surgery predicted risk of in-hospital mortality was similar for OPCAB (5.4%) and ONCAB (5.3%) patients (P = 0.81). However, observed in-hospital mortality was improved for patients in the OPCAB group (OPCAB: 15/540, 2.8% vs ONCAB: 37/397, 9.3%, P = 0.007). Ten-year survival was similar between groups (OPCAB: 28.8% vs ONCAB: 26.3%, P = 0.22). Conclusions In this series, OPCAB reduced the incidence of in-hospital mortality compared with ONCAB. Long-term mortality was similar between groups.

24-Hour In-hospital Mortality Predictions in Coronary Artery Bypass Grafting Patients

2007 ◽  
Vol 38 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Hossein Ahmadi ◽  
Abbasali Karimi ◽  
Saeed Davoodi ◽  
Mehrab Marzban ◽  
Namvar Movahedi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Determinants of Hospital Mortality After Coronary Artery Bypass Grafting

CHEST Journal ◽  
1999 ◽  
Vol 115 (6) ◽  
pp. 1598-1603 ◽  
Author(s):  
Argyris Michalopoulos ◽  
George Tzelepis ◽  
Urania Dafni ◽  
Stefanos Geroulanos
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting
Sign in / Sign up

Export Citation Format

Share Document