Short-Term and Mid-Term Clinical Outcomes Following Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery Bypass: A Meta-Analysis

Liu, Dong; Kang, Yuan; An, Xiangguang

doi:10.5935/abc.20180044

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…In a left-dominant system, the posterior descending artery (PDA) is supplied by the circumflex artery. In a right-dominant system, the PDA is supplied by the RCA [24] . In this meta-analysis, we included nine trials with a total of 7100 patients and 1440 grafts under individual or sequential coronary artery bypass.…”

Section: Discussionmentioning

confidence: 99%

Patency of Individual and Sequential Coronary Artery Bypass in Patients with Ischemic Heart Disease: A Meta-analysis

Li¹,

Liu²

2019

Braz J Cardiovasc Surg

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Objective To evaluate the patency of individual and sequential coronary artery bypass in patients with ischemic heart disease. Methods We searched PubMed, Cochrane Library, Excerpta Medica Database, and ClinicalTrials.gov databases for controlled trials. Endpoints included graft patency, anastomosis patency, occluded rates in left anterior descending (LAD) system and right coronary artery (RCA) system, in-hospital mortality, and follow-up mortality. Pooled risk ratios (RRs) and standardized mean difference (SMD) were used to assess the relative data. Results Nine cohorts, including 7100 patients and 1440 grafts under individual or sequential coronary artery bypass. There were no significant differences between individual and sequential coronary artery bypass in the graft patency (RR=0.96; 95% CI=0.91-1.02; P =0.16; I 2 =87%), anastomosis patency (RR=0.95; 95% CI=0.91-1.00; P =0.05; I 2 =70%), occluded rate in LAD system (RR=1.03; 95% CI=0.92-1.16; P =0.58; I 2 =37%), occluded rate in RCA system (RR=1.36; 95% CI=0.72-2.57; P =0.35; I 2 =95%), in-hospital mortality (RR=1.57; 95% CI=0.92-2.69; P =0.10; I 2 =0%), and follow-up mortality (RR=0.96; 95% CI=0.36-2.53; P =0.93; I 2 =0%). Conclusion No significant differences on clinical data were observed regarding anastomosis patency, occluded rate in LAD system, occluded rate in RCA system, in-hospital mortality, and follow-up mortality, indicating that the patency of individual and the patency of sequential coronary artery bypass are similar to each other.

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Section: Discussionmentioning

confidence: 99%

Patency of Individual and Sequential Coronary Artery Bypass in Patients with Ischemic Heart Disease: A Meta-analysis

Li¹,

Liu²

2019

Braz J Cardiovasc Surg

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“…12 Furthermore, a low rate of MACE and re-exploration for bleeding was observed. 13,14 Angiographic follow-up showed an excellent LIMA to LAD anastomotic and stent patency among RHCR patients. RHCR has numerous advantages but also some disadvantages.…”

Section: Discussionmentioning

confidence: 89%

“…The adoption of robotic assistance led to a better visual field, thus reducing the possibility of LIMA injury during harvesting 12 . Furthermore, a low rate of MACE and re‐exploration for bleeding was observed 13,14 . Angiographic follow‐up showed an excellent LIMA to LAD anastomotic and stent patency among RHCR patients 14 …”

Section: Discussionmentioning

confidence: 97%

A robotic‐assisted hybrid coronary revascularization program: Establishment and early experience in the Middle East

Aluthman

Bafageeh

Ashour

et al. 2022

Journal of Cardiac Surgery

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Background Hybrid coronary revascularization (HCR) is a technique that merges coronary artery bypass grafting surgery and percutaneous coronary intervention (PCI) approaches for the treatment of multivessel coronary artery disease. The surgical component of the procedure is minimally invasive and can be done using robotic technology that avoids the need for sternotomy. Our objective is to study all patients who underwent robotic‐assisted HCR (RHCR) to evaluate the feasibility and safety of the procedure during the establishment phase. Methods This study is a retrospective chart review conducted at King Faisal Specialist Hospital and Research Centre in Jeddah (KFSRC‐J). The study focuses on patients who underwent RHCR between July 2018 to December 2020. The study was approved by the institutional review board #2020‐103. Results Robotic‐assisted HCR was performed on 78 patients (mean age, 56 years (range, 43–72 years); 89.75% males) during the study phase. Left internal mammary artery grafting was used in all patients. There was no hospital mortality, and the mean hospital and intensive care unit (ICU) stay were 5.8 and 1.4 days, respectively. We found that 93.6% of the patients had no blood transfusion. There were no major adverse cardiac events (MACE) and perioperative MI recorded. There was a 3.8% rate of postoperative complications. The percentage of surgeries converted to conventional and re‐exploration for bleeding were 1.2% and 2.6%, respectively. The average operation time was 164 min. Conclusion This study emphasizes on the safety and effectiveness of RHCR in treating patients with multivessel coronary artery disease. Moreover, robotic‐assisted hybrid coronary revascularization offers an alternative, functionally complete revascularization option to a selected group of patients with minimal surgical trauma, short hospital and ICU length of stay, quick recovery, and little to no blood transfusion requirement.

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“…The cost of HCR was compared to OPCAB in a meta-analysis by Dong et al that demonstrated increased cost with HCR despite shorter ICU and hospital stay and decreased transfusion rates. 84 Bachinsky et al also showed higher cost for HCR compared to OPCAB despite lower postoperative cost ($33,984 ± $4,806 vs $27,816 ± $11,172). 85 However, Halkos et al showed that HCR results in a greater contribution margin for hospitals in comparison to OPCAB possibly due to higher reimbursement in the United States and improved postoperative resource utilization.…”

Section: Hybrid Coronary Revascularizationmentioning

confidence: 93%

Review of Contemporary Techniques for Minimally Invasive Coronary Revascularization

Hassanabad

Kang

Maitland

et al. 2021

Innovations�(Phila)

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Minimally invasive coronary revascularization techniques aim to avoid median sternotomy with its associated complications, while facilitating recovery and maintaining the benefits of surgical revascularization. The 3 most common procedures are minimally invasive coronary artery bypass grafting, totally endoscopic coronary artery bypass, and hybrid coronary revascularization. For a variety of reasons, including cost and technical difficulty, not many centers are routinely performing minimally invasive coronary revascularization. Nevertheless, many studies have assessed the safety and efficacy of each of these procedures in different clinical contexts. Thus far results have been promising, and with the evolution of procedural techniques, these approaches have the potential to redefine coronary revascularization in the future. This review highlights the current state of minimally invasive coronary revascularization techniques by exploring their benefits, identifying barriers to their adoption, and discussing future potential paradigms.

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Short-Term and Mid-Term Clinical Outcomes Following Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery Bypass: A Meta-Analysis

Cited by 5 publications

References 37 publications

Patency of Individual and Sequential Coronary Artery Bypass in Patients with Ischemic Heart Disease: A Meta-analysis

Patency of Individual and Sequential Coronary Artery Bypass in Patients with Ischemic Heart Disease: A Meta-analysis

A robotic‐assisted hybrid coronary revascularization program: Establishment and early experience in the Middle East

Review of Contemporary Techniques for Minimally Invasive Coronary Revascularization

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