Impact of Arterial Revascularization in Patients Undergoing Coronary Bypass

Nasso, Giuseppe; Popoff, Georges; Lamarra, Mauro; Romano, Vito; Coppola, Roberto; Bartolomucci, Francesco; Giglio, Mauro Del; Romeo, Francesco; Tavazzi, Luigi; Saglio, Giuseppe

doi:10.1111/j.1540-8191.2012.01481.x

Cited by 12 publications

(19 citation statements)

References 24 publications

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“…Funnel plots (Figure S7) and linear regression analysis ( P .20) did not show asymmetry. The sensitivity analysis did not change the final result with one exception: higher risk of sternal deep infection of TAR over non‐TAR was not confirmed when excluding the study by Nasso et al (Figure S8).…”

Section: Resultsmentioning

confidence: 86%

“…Studies were excluded for the following reasons: no comparison between TAR and non‐TAR strategy (n = 32), sample population derived from a previously published and included series (n = 1), and lack of propensity score matching (n = 1). Consequently, 18 articles were included in our study . Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7).…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, 10 described a BIMA usage of ≥80%. For this reason, they were assigned to the category “TAR with BIMA” . The remaining 4 studies were categorized as “TAR without BIMA” (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Consequently, 18 articles were included in our study. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Mean age and mean body mass index of the included populations were 65.6 years (±7.6) and 27.1 (±1.7). Thirty percent of the population presented with diabetes and 18.9% were female patients (Table S1).…”

Section: Resultsmentioning

confidence: 99%

“…For this reason, they were assigned to the category "TAR with BIMA". 16,17,[21][22][23][25][26][27]30,31 The remaining 4 studies were categorized as "TAR without BIMA" 19,20,29,32 (Figure 1). The percentages of patients of the TAR group receiving BIMA in these four studies were: Buxton 2012 = 16% 19 ; Buxton 2014 = 36% 20 ; Royse = 0% 29 ; and Tatoulis = 22%.…”

Section: Resultsmentioning

confidence: 99%

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Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

et al. 2019

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Background and Aim of the Study We explored the current evidence available on total arterial revascularization (TAR) carrying out a meta‐analysis of propensity score‐matched studies comparing TAR versus non‐TAR strategy. Methods PubMed, EMBASE, and Google Scholar were searched for propensity score‐matched studies comparing TAR vs non‐TAR. The generic inverse variance method was used to compute the combined hazard ratio (HR) of long‐term mortality. The Der‐Simonian and Laird method were used to compute the combined risk ratio (RR) of 30‐day mortality, deep sternal wound infection, and reoperation for bleeding. Results Eighteen TAR vs non‐TAR matched populations were included. Meta‐analysis showed a significant benefit in terms of long‐term survival of the TAR group over the non‐TAR group (HR: 0.73; 95% confidence interval [CI]: 0.68‐0.78). Better long‐term survival over non‐TAR strategy was confirmed by both subgroups: TAR with the bilateral internal mammary artery (BIMA) and TAR without BIMA. Meta‐regression suggests that TAR may offer a higher protective survival effect in diabetic patients (coefficient: −0.0063; 95% CI: −0.01 to 0.0006), when carried out with BIMA (coefficient: −0.15; 95% CI: −0.27 to −0.03) or using three arterial conduits (coefficient: −0.12; 95% CI: −0.25 to 0.007). A TAR strategy carried out using BIMA, differently from TAR without BIMA, increases the risk of deep sternal infection (RR: 1.44; 95% CI: 1.17‐1.77). Conclusions TAR provides a long‐term survival benefit compared with the non‐TAR strategy. Also, compared with TAR without BIMA, TAR with BIMA may offer a higher protective long‐term survival effect at the expense of a higher risk of sternal deep wound infection.

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Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

et al. 2019

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Current trends in selection of conduits for coronary artery bypass grafting

Carrel

Winkler

2017

Gen Thorac Cardiovasc Surg

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The procedure of coronary artery bypass grafting continues to be the "gold standard" for patients with multivessel coronary artery disease and left main stenosis due to favourable long-term and consistent outcomes despite the advent of new generations of stents. But the targeted better long-term outcome of surgical revascularization over percutaneous interventions depends on several variables and aspects; one of them is the choice of conduits used to bypass the stenosed arteries. Coronary artery bypass surgery has been studied and debated for decades and the same applies to the selection of grafts. Current data provide significant benefits for patients who receive full arterial revascularization using both internal thoracic arteries and, if applicable, the radial artery. Unfortunately, the use of multiple arterial grafts is still not performed widely despite the evidence of superiority over multiple saphenous vein grafts that are still the most used grafts in cardiovascular procedures. In this review article, we present current trends and evidences for graft selection and give an overview of controversial data regarding the comparison of the radial artery and saphenous vein. Additionally, few words are spelt on alternative conduits.

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Impact of total arterial revascularization on long term survival: A systematic review and meta-analysis of 130,305 patients

Yanagawa

Verma

Mazine

et al. 2017

International Journal of Cardiology

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Impact of Arterial Revascularization in Patients Undergoing Coronary Bypass

Abstract: These data strongly support the practice of using two arterial conduits rather than one. The operative and late results of coronary surgery with arterial conduits are optimal and should serve as a current benchmark for the comparison with state-of-the-art percutaneous interventions.

Cited by 12 publications

References 24 publications

Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

Total arterial revascularization strategies: A meta‐analysis of propensity score‐matched observational studies

Current trends in selection of conduits for coronary artery bypass grafting

Impact of total arterial revascularization on long term survival: A systematic review and meta-analysis of 130,305 patients

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