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Ipek G, Kehlibar T, Keskin M, Yilmaz H, Ketenci B, Bolca O. Outcomes of Coronary Artery By-Pass Grafting Under Dual Antiplatelet Therapy in ST Elevated Myocardial Infarction. Angiology 2023; 74:374-380. [PMID: 35732598 DOI: 10.1177/00033197221110696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with recent myocardial infarction (MI) or percutaneous coronary interventions (PCI) have a higher ischemic risk in addition to perioperative bleeding risk when undergoing coronary artery bypass grafting (CABG). Data regarding preoperative dual antiplatelet therapy (DAPT) failed to create a clear recommendation. In the present study, we assessed the relationship between preoperative DAPT use and adverse outcomes, particularly in ST-elevation MI (STEMI) patients. We retrospectively analyzed 748 consecutive patients with STEMI who underwent subsequent CABG surgery. Patients were divided into 2 groups: those on DAPT up to the day before CABG and those discontinued DAPT >5 days before CABG. Predictors of in-hospital mortality and major bleeding were analyzed by multivariate analysis. Preoperative DAPT was not associated with in-hospital mortality (Odds Ratio (OR):1.81; 95% Confidence Interval (CI): .89-3.68, P = .10) and major bleeding (OR: 1.15; 95% CI: .63-2.08, P = .65) after multivariate analysis. However, glycoprotein (Gp) 2b/3a inhibitors were independently associated with higher major bleeding rates. Age, shock, and EF (ejection fraction) <30% were associated with in-hospital mortality. Previous MI, Gp 2b/3a inhibitors, and EF <30% were predictors of major bleeding. In conclusion, there were no association between pre-CABG DAPT use and in-hospital mortality and major bleeding.
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Affiliation(s)
- Gokturk Ipek
- Department of Cardiology, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Tamer Kehlibar
- Department of Cardiovascular Surgery, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Muhammed Keskin
- Department of Cardiology, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Hale Yilmaz
- Department of Cardiology, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Bulent Ketenci
- Department of Cardiovascular Surgery, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Osman Bolca
- Department of Cardiology, RinggolID: 111319SiyamiErsek Cardiothoracic Surgery Center, Istanbul, Turkey
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2
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Rando H, Kilic A. Intraoperative ventricular septal rupture: A case report. Clin Case Rep 2023; 11:e7017. [PMID: 37064732 PMCID: PMC10090934 DOI: 10.1002/ccr3.7017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/03/2022] [Accepted: 02/13/2023] [Indexed: 04/18/2023] Open
Abstract
Ventricular septal rupture (VSR) is a rare complication of myocardial infarction that requires surgical repair. Herein, we describe a case of intraoperative VSR requiring patch repair and postoperative extracorporeal membrane oxygenation (ECMO) support. This case highlights the risk factors, patient presentation, and management recommendations for this potentially lethal pathology.
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Affiliation(s)
- Hannah Rando
- Division of Cardiac Surgery, Department of SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Ahmet Kilic
- Division of Cardiac Surgery, Department of SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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3
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The Effect of Off-Pump Coronary Artery Bypass Grafting in Patients on Aspirin Therapy until Surgery Day. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8674401. [PMID: 35854767 PMCID: PMC9286924 DOI: 10.1155/2022/8674401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/30/2022]
Abstract
Coronary artery bypass grafting (CABG) is widely used to treat coronary artery disease, and intraoperative and postoperative bleeding is one of the major factors affecting the efficacy and mortality of CABG. To overcome the adverse effects of extracorporeal circulation (CPB), nonextracorporeal coronary artery bypass grafting (OPCABG) has become the main modality of CABG but is still prone to thromboembolic events. Whether antiplatelet agents should be clinically applied before CABG, especially OPCABG, remains controversial. Aspirin is currently the most important perioperative oral antiplatelet agent for coronary artery bypass graft surgery. In this study, we evaluated the effect of continuing aspirin therapy before OPCABG and observed perioperative performance and physiological indicators to find evidence for continuing aspirin therapy before surgery in China. The study showed that preoperative aspirin application had a positive effect on enhancing early postoperative platelet inhibition without increasing the incidence of adverse effects such as cardiovascular events. This provides an important clinical reference for whether antiplatelet agents should be applied before CABG, especially OPCABG.
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Salenger R, Mazzeffi MA. The 7 Pillars of Blood Conservation in Cardiac Surgery. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2021; 16:504-509. [PMID: 34821153 DOI: 10.1177/15569845211051683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rawn Salenger
- Division of Cardiac Surgery, 12264University of Maryland School of Medicine, Baltimore, MD, USA.,University of Maryland Saint Joseph Medical Center, Towson, MD, USA.,Departments of Anesthesiology and Critical Care Medicine, 43989George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Michael A Mazzeffi
- Division of Cardiac Surgery, 12264University of Maryland School of Medicine, Baltimore, MD, USA.,University of Maryland Saint Joseph Medical Center, Towson, MD, USA.,Departments of Anesthesiology and Critical Care Medicine, 43989George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Sarathy K, Wells GA, Singh K, Couture E, Chong AY, Rubens F, Lordkipanidzé M, Tanguay JF, So D. Platelet Quiescence in Patients With Acute Coronary Syndrome Undergoing Coronary Artery Bypass Graft Surgery. J Am Heart Assoc 2021; 10:e016602. [PMID: 33599134 PMCID: PMC8174246 DOI: 10.1161/jaha.120.016602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The optimal antiplatelet strategy for patients with acute coronary syndromes who require coronary artery bypass surgery remains unclear. While a more potent antiplatelet regimen will predispose to perioperative bleeding, it is hypothesized that through "platelet quiescence," ischemic protection conferred by such therapy may provide a net clinical benefit. Methods and Results We compared patients undergoing coronary artery bypass surgery who were treated with a more potent antiplatelet inhibition strategy with those with a less potent inhibition through a meta-analysis. The primary outcome was all-cause mortality after bypass surgery. The analysis identified 4 studies in which the antiplatelet regimen was randomized and 6 studies that were nonrandomized. Combining all studies, there was an overall higher mortality with weaker strategies compared with more potent strategies (odds ratio, 1.38; 95% CI, 1.03-1.85; P=0.03). Conclusions Our findings support the concept of platelet quiescence, in reducing mortality for patients with acute coronary syndrome requiring coronary artery bypass surgery. This suggests the routine up-front use of potent antiplatelet regimens in acute coronary syndrome, irrespective of likelihood of coronary artery bypass graft.
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Affiliation(s)
- Kiran Sarathy
- University of Ottawa Heart Institute Ottawa Ontario Canada
| | - George A Wells
- University of Ottawa Heart Institute Ottawa Ontario Canada
| | - Kuljit Singh
- Gold Coast University Hospital Queensland Australia
| | | | | | - Fraser Rubens
- University of Ottawa Heart Institute Ottawa Ontario Canada
| | | | | | - Derek So
- University of Ottawa Heart Institute Ottawa Ontario Canada
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6
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Cheng Y, Liu X, Zhao Y, Sun Y, Zhang D, Liu F, Ma Y, Zhou Y. Risk Factors for Postoperative Events in Patients on Antiplatelet Therapy Undergoing Off-Pump Coronary Artery Bypass Grafting Surgery. Angiology 2020; 71:704-712. [PMID: 32295386 DOI: 10.1177/0003319720919319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This retrospective study assessed the risk factors for adverse events following off-pump coronary artery bypass graft (CABG) surgery with dual antiplatelet therapy (DAPT). Records (between 2013 and 2017) were reviewed for patients who discontinued DAPT (clopidogrel 75 mg and aspirin 100 mg) ≤5 days before off-pump CABG. The primary outcome was the incidence of a Bleeding Academic Research Consortium (BARC) type 4 major event. Factors associated with bleeding events and perioperative myocardial ischemia were evaluated using multivariable logistic regression. The incidence of major bleeding events was 17.6% in 2012 patients. Adjusted multiple logistic regression analysis showed that the risk of postoperative bleeding increased when DAPT was discontinued <3 days before surgery (day 2: adjusted odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.09-2.64; day 1: adjusted OR: 2.37, 95% CI: 1.49-3.77; day 0: adjusted OR: 2.45, 95% CI: 1.53-3.92). The adjusted risk of mortality (OR: 13.14, 95% CI: 4.55-37.94) was increased with bleeding complications. In subgroup analysis, perioperative myocardial ischemia was related to increased blood loss (adjusted OR: 1.10, 95% CI: 1.02-1.18). Aspirin and clopidogrel should optimally be discontinued >3 days before CABG to reduce the risk of bleeding complications, myocardial ischemia, and death.
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Affiliation(s)
- Yujing Cheng
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Xiaoli Liu
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yingxin Zhao
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yan Sun
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Dai Zhang
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Fang Liu
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yue Ma
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Department of Cardiology, 12th ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
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Karlsson M, Hannuksela M, Appelblad M, Hällgren O, Johagen D, Wahba A, Svenmarker S. Cardiopulmonary bypass and dual antiplatelet therapy: a strategy to minimise transfusions and blood loss. Perfusion 2019; 35:236-245. [PMID: 31446845 DOI: 10.1177/0267659119867005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Patients with preoperative dual antiplatelet therapy prior to coronary artery bypass surgery are at risk of bleeding and blood component transfusion. We hypothesise that an optimised cardiopulmonary bypass strategy reduces postoperative blood loss and transfusions. METHODS In total, 60 patients admitted for coronary artery bypass grafting with ticagrelor and aspirin medication withdrawn <96 hours before surgery were prospectively randomised into two equal sized groups. Cardiopulmonary bypass combined a closed Cortiva® heparin-coated circuit with low systemic heparinisation (activated clotting time < 250 seconds) and intraoperative cell salvage in the study group, whereas the control group used a Balance® coated open circuit, full systemic heparinisation (activated clotting time > 480 seconds) and conventional cardiotomy suction. This perfusion strategy was evaluated by the chest drain volume after 24 hours, perioperative haemoglobin and platelet loss accompanied by global coagulation assessments. RESULTS Patients in the study group demonstrated significantly better outcomes signified by lower blood loss 554 ± 224 versus 1,100 ± 989 mL (p < 0.001), reduced packed red cell transfusion 7% versus 53% (p < 0.001), reduced haemoglobin -28 ± 15 versus -40 ± 14 g/L (p = 0.004) and platelet loss -35 ± 36 versus -82 ± 67 × 109/L (p = 0.001). Indices of rotational thromboelastometry indicated shorter clotting times within the internal and external pathways. Adenosine diphosphate activated platelet function was within normal range based on Multiplate® aggregometry, while ROTEM® platelet analyses indicated inhibited function both preoperatively and post-bypass. Platelet inhibition by aspirin was verified throughout the perioperative period. Platelet function showed no intergroup differences. CONCLUSION A stringent perfusion strategy reduced blood loss and transfusions in dual antiplatelet therapy patients requiring urgent surgery.
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Affiliation(s)
- Mattias Karlsson
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
| | - Matias Hannuksela
- Department of Surgical and Perioperative Sciences, Heart Centre, Umeå University, Umeå, Sweden
| | - Micael Appelblad
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
| | - Oskar Hällgren
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
| | - Daniel Johagen
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
| | - Alexander Wahba
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Staffan Svenmarker
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
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Comparison of In-Hospital Outcomes of Patients With-Versus-Without Ischemic Cardiomyopathy Undergoing Left Ventricular Assist Device Placement. Am J Cardiol 2019; 123:414-418. [PMID: 30545482 DOI: 10.1016/j.amjcard.2018.10.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/21/2018] [Accepted: 10/25/2018] [Indexed: 01/04/2023]
Abstract
The objective of this study was to evaluate the impact of heart failure (HF) etiology (ischemic cardiomyopathy [ICM] versus nonischemic cardiomyopathy) on in-hospital outcomes in patients undergoing left ventricular assist device (LVAD) placement using the Nationwide Inpatient Sample database. We identified patients who underwent LVAD placement from 2011 to 2014. The primary end point was the effect of ICM on in-hospital mortality. Secondary end points included periprocedural vascular complications requiring surgery, postoperative myocardial infarction, stroke, and hemorrhage requiring transfusion. We also assessed length of stay and cost of hospitalization. A mixed effects logistic model was used for clinical end points and a linear mixed model was used for cost and length of stay. In 3,511 patients who underwent LVAD placement (23.32% women and 56.23 ± 13.51 years old), the incidence of ICM was 53.5%. After adjusting for patient- and hospital-level characteristics, ICM was not found to influence in-hospital mortality (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.78 to 1.23). ICM was associated with an increased risk in periprocedural hemorrhage requiring transfusion (OR 1.29, 95% CI 1.08 to 1.53), vascular complications requiring surgery (OR 1.58 95% CI 1.10 to 2.28) and postoperative ST-segment myocardial infarction (OR 7.38 95% CI 5.33 to 10.24). In conclusion, ICM did not impact in-hospital mortality in patients who underwent LVAD placement but was associated with increased vascular complications, hemorrhage requiring transfusion, and postoperative myocardial infarction.
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Kizilay M, Aslan Z, Vural U, Balci AY, Aglar AA, Yilmaz S. Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery? Braz J Cardiovasc Surg 2019; 33:330-338. [PMID: 30184029 PMCID: PMC6122766 DOI: 10.21470/1678-9741-2018-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/27/2018] [Indexed: 11/23/2022] Open
Abstract
Objective The aims of this study were to determine whether the detection of
preoperative clopidogrel resistance in patients undergoing cardiac surgery
while using clopidogrel could play a guiding role in the prediction of
postoperative excessive bleeding, transfusion requirements, and risks and to
provide clinically significant data. Methods Two hundred and twenty-two patients [median age: 59.4 (38-83) years;
38 females] undergoing emergency and elective coronary artery bypass
graft (CABG) surgeries in our clinic were evaluated prospectively. Patients
with multiple systemic diseases, other than diabetes mellitus (DM) and
hypertension (HT), were excluded. Patients receiving clopidogrel were also
evaluated for clopidogrel resistance and grouped according to the results of
this test. Assessments of platelet functions were performed by multiplate
impedance aggregometry method and adenosine diphosphate test. Results The use of postoperative fresh blood replacement and platelet transfusion was
higher in patients receiving clopidogrel than in those not receiving it
(P=0.001, P=0.018). DM, HT, myocardial
infarction, and the number of presentation to the emergency room were
significantly higher in patients receiving clopidogrel than in those not
receiving it (P<0.05). No significant difference was
determined between patients with and without clopidogrel resistance
regarding the amount of bleeding during and after surgery, erythrocyte
suspension and fresh-frozen plasma transfusion rates, preoperative troponin
values, ejection fraction values, and length of hospital stays
(P>0.05). Conclusion We think that resistance studies in patients receiving clopidogrel before
cardiac surgery are not efficient to predict bleeding and bleeding-related
complications in patients undergoing emergency and elective CABG
surgeries.
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Affiliation(s)
- Mehmet Kizilay
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Zeynep Aslan
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, University of Health Sciences, Derince, Kocaeli, Turkey
| | - Unsal Vural
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Ahmet Yavuz Balci
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Ahmet Arif Aglar
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Sahin Yilmaz
- Department of Anesthesiology, Dr. Siyami Ersek Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
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10
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Grieshaber P, Oster L, Schneider T, Johnson V, Orhan C, Roth P, Niemann B, Böning A. Total arterial revascularization in patients with acute myocardial infarction - feasibility and outcomes. J Cardiothorac Surg 2018; 13:2. [PMID: 29304874 PMCID: PMC5755408 DOI: 10.1186/s13019-017-0691-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/20/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In acute situations such as acute myocardial infarction (AMI) with indication for coronary artery bypass grafting (CABG), total arterial revascularization (TAR) is often rejected in favour of saphenous vein (SV) grafting, which is assumed to allow for quicker vessel harvesting, a simpler anastomosis technique, and thus quicker revascularization and fewer bleeding complications. The aim of this study was to evaluate whether reluctance to apply TAR in AMI is still justified from a technical point of view in the current era and whether superiority of TAR results is also evident in emergency patients with AMI undergoing CABG. METHODS In this retrospective analysis of 434 consecutive patients undergoing CABG for AMI with either TAR or with a combination of one internal mammary artery and SV grafts between 2008 and 2014, procedural data, short-term and mid-term outcome were compared. Propensity score matching of the groups was performed. RESULTS After propensity score matching, 250 patients were included in the analysis (TAR group: n = 98; SV group n = 152). The procedural time (TAR group: 211 min vs. SV group: 200 min, p = 0.46) did not differ between the groups. Erythrocyte transfusion rates were higher in the SV group (76% vs. 57%; p < 0.001). Rates of re-exploration for bleeding did not differ. Thirty-day mortality rates were comparable (TAR group: 3.4% vs. SV group: 4.5%, p = 0.68). Kaplan-Meier analysis until 7 years postoperatively revealed a tendency for improved survival after TAR (75% vs. 62%; log-rank p = 0.12). CONCLUSION TAR neither impairs rapid revascularization nor reduces its safety in patients with AMI. It may result in improved long-term outcome and should be preferred in the clinical setting of AMI.
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Affiliation(s)
- Philippe Grieshaber
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
| | - Lukas Oster
- Department of Anaesthesiology, Sana Hospital Berlin-Lichtenberg, Berlin, Germany
| | - Tobias Schneider
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
| | - Victoria Johnson
- Department of Cardiology and Angiology, University Hospital Giessen, Giessen, Germany
| | - Coskun Orhan
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
| | - Peter Roth
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
| | - Bernd Niemann
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
| | - Andreas Böning
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, DE-35392 Giessen, Germany
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Mannacio V, Mannacio L, Antignano A, Pinna GB. Antiplatelet therapy suspension in patients undergoing coronary surgery for acute coronary syndrome: Is point-of-care guided strategy the best choice? J Cardiol 2017; 70:402-403. [PMID: 28410892 DOI: 10.1016/j.jjcc.2017.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/17/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Vito Mannacio
- Department of Cardiac Surgery, University Federico II, School of Medicine, Naples, Italy.
| | - Luigi Mannacio
- Department of Cardiac Surgery, University Federico II, School of Medicine, Naples, Italy
| | - Anita Antignano
- Department of Cardiology, Azienda Ospedaliera Santobono-Pausillipon, Naples, Italy
| | - Giovanni B Pinna
- Department of Cardiac Surgery, University Federico II, School of Medicine, Naples, Italy
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Tsukahara K. Authors' reply. J Cardiol 2017; 70:403. [PMID: 28385498 DOI: 10.1016/j.jjcc.2017.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Kengo Tsukahara
- Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-Cho Minami-Ku Yokohama, 232-0024 Japan.
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