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Thakare VS, Sontakke NG, Wasnik P, Kanyal D. Recent Advances in Coronary Artery Bypass Grafting Techniques and Outcomes: A Narrative Review. Cureus 2023; 15:e45511. [PMID: 37868547 PMCID: PMC10585183 DOI: 10.7759/cureus.45511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Coronary artery bypass grafting (CABG) has witnessed remarkable progress in recent years, driven by innovative techniques and refined approaches that have transformed patient outcomes and treatment paradigms. This review article comprehensively explores the latest advances in CABG techniques and their consequential impacts on patient outcomes. The advent of minimally invasive CABG techniques has revolutionized traditional surgical approaches. Robotic-assisted surgery and small thoracotomy methods offer reduced invasiveness, yielding shorter recovery times and improved patient satisfaction. Integrating CABG with percutaneous coronary intervention (PCI), hybrid procedures have emerged as a versatile strategy, providing tailored treatment solutions for complex coronary anatomies. The paradigm shift to off-pump CABG, which preserves the beating heart during surgery, has shown promise in reducing perioperative complications and neurocognitive deficits. Advances in graft selection, particularly the utilization of arterial grafts such as the internal thoracic artery and radial artery, have significantly enhanced graft patency rates and long-term survival. Adjunctive technologies, such as intraoperative imaging and graft flow assessment, have bolstered the precision of CABG procedures. Pharmacological agents have demonstrated their potential to improve graft outcomes. Surgical decision-making is now optimized based on patient characteristics and disease severity owing to the development of patient selection and risk stratification tools. Long-term results have also significantly improved. Patients undergoing CABG have higher survival rates, less angina, and better quality of life. Developing more resilient grafts through tissue engineering, using bioresorbable materials in graft fabrication, and using gene therapy to improve graft patency and overall cardiac recovery are all exciting future research directions. This review's summary of current developments in CABG procedures highlights their profoundly positive effects on patient outcomes. These developments can change the face of cardiovascular care by giving clinicians more tools to treat coronary artery disease (CAD) and enhance patients' quality of life.
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Affiliation(s)
- Vaishnavi S Thakare
- Hospital Administration, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikhil G Sontakke
- Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Praful Wasnik
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Deepika Kanyal
- Hospital Administration, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Machado MDSR, Bertagnolli TV, Veiga ECDA, Ferreira CJH, Duarte G, Machado JDSR, Carvalho R. Multiprofessional care promotes of quality of life in pregnant women with preeclampsia: a cross-sectional study. Clinics (Sao Paulo) 2020; 75:e1951. [PMID: 33146357 PMCID: PMC7561055 DOI: 10.6061/clinics/2020/e1951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the quality of life of hospitalized pregnant women with preeclampsia (PE), and compare with a group of healthy pregnant women (HP). METHODS This was an observational cross-sectional study conducted among 58 pregnant women; 28 of them had preeclampsia and 30 were healthy. The WHOQOL-Bref questionnaire, which was divided into four aspects: physical, psychological, social, and environmental, was applied to each subject. RESULTS A statistically significant difference was observed regarding maternal age (PE 27.8±6.2 x HG 23.0±6.6, p<0.01) and gestational age (PE 224±28.1 x HG 253.8±43.7, p<0.01) in relation to the clinical and obstetric data. No significant difference was observed among groups in the physical (PE 57.7±18.9 x HG 65.7±16.6, p=0.19), psychological (PE 68.2±12.8 x HG 73.3±13.30, p=0.16), social (PE 72.0±15.8 x HG 71.7±18.7, p=0.78), or environmental (PE 61.1±11.9 x HG 59.3±15.9, p=0.88) aspects of the WHOQOL-Bref. CONCLUSION There was no difference in quality of life between the groups studied, a result possibly due to the fact that women with PE were hospitalized and received multiprofessional care.
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Affiliation(s)
- Michelle de Souza Rangel Machado
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Tawana Vicente Bertagnolli
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Eduardo Carvalho de Arruda Veiga
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Cristine Jorge Homsi Ferreira
- Departamento de Biomecanica, Medicina e Reabilitacao do Aparelho Locomotor da Faculdade de Medicina de Ribeirão Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Geraldo Duarte
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
| | | | - Ricardo Carvalho
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), SP, BR
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Pačarić S, Turk T, Erić I, Orkić Ž, Petek Erić A, Milostić-Srb A, Farčić N, Barać I, Nemčić A. Assessment of the Quality of Life in Patients before and after Coronary Artery Bypass Grafting (CABG): A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041417. [PMID: 32098322 PMCID: PMC7068373 DOI: 10.3390/ijerph17041417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/21/2023]
Abstract
The aim of this study was to examine the quality of life and to report on the utility and QALY measures in patients before and after coronary artery bypass grafting (CABG); to investigate whether the SF-12 is comparable with the SF-36 for measuring health-related quality of life of patients with CABG; and to determine the impact of individual predictors on poor quality of life assessment after rehabilitation. This prospective study was conducted between January 2017 and December 2018 at the University Hospital Center Osijek, at three time points: pre-operation, 1 month after surgery, and after rehabilitation. The study was conducted with the SF-36 and SF-12 health questionnaires on 47 participants. After rehabilitation, there was a significant improvement in all domains of quality of life. The highest score was given to the change in pain (BP); mean scores were 63.8 (95% CI 56.9 to 70.6) (p = 0.001). The lowest grade (the lowest quality) after rehabilitation was in the domain of limitations due to physical difficulties (RP); arithmetic mean was 48.5 (95% CI 41 to 55.9) (p < 0.001). Quality-adjusted life-year was 0.41 (95% CI 0.38–0.44) after the CABG. The results of this study show that patients with coronary heart disease have poor quality of life before surgery. One month after the surgery, the quality of life improved, but was still inadequate. One year after surgery, satisfactory results were obtained in almost all subscales. The SF-36, SF-12, and its components, can be used effectively in patients with CABG. Age, gender, lifestyle, and risk factors in our sample of participants are not predictors of poor quality of life assessment after rehabilitation.
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Affiliation(s)
- Stana Pačarić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Tajana Turk
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Ivan Erić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Želimir Orkić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
| | - Anamarija Petek Erić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Andrea Milostić-Srb
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Nikolina Farčić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
- Correspondence: ; Tel.: +385-98-186-85-69
| | - Ivana Barać
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31 000, Croatia; (A.M.-S.); (I.B.)
| | - Ana Nemčić
- University Hospital Centre Osijek, Osijek 31 000, Croatia; (S.P.); (T.T.); (I.E.); (Ž.O.); (A.P.E.); (A.N.)
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