Short and Midterm Outcomes of Elective Total Aortic Arch Replacement Combined With Coronary Artery Bypass Grafting

Okada, Kenji; Omura, Atsushi; Hiroya, Kou; Ohara, Taimi; Shirasaka, Tomonori; Yamanaka, Katsuhiro; Miyahara, Shunsuke; Sakamoto, Toshihito; Tanaka, Akiko; Inoue, Takeshi; Oka, Toshihiko; Minami, Hiroya; Okita, Yutaka

doi:10.1016/j.athoracsur.2012.04.034

Cited by 17 publications

(16 citation statements)

References 22 publications

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“…Although McFalls et al in a randomized study found no benefit from intervention in patients with asymptomatic CAD who are to undergo major vascular procedures such as abdominal aortic aneurysm repair, we advocate in favor of coronary intervention. We feel this can be performed with minimal risk and serves to prevent perioperative myocardial infarction and other cardiac events . Sprung et al found that prior coronary artery bypass reduced perioperative mortality by 79% in patients who developed myocardial infarction following major vascular surgery …”

Section: Discussionmentioning

confidence: 98%

“…The presence of coronary artery disease (CAD) accompanying disease of the descending thoracic aorta (DTA) has been recognized and regarded as one of the principal causes of mortality following operations on the thoracic aorta . Unlike ascending aortic pathology, atherosclerosis is a major risk factor for development of disease of the DTA .…”

mentioning

confidence: 99%

“…The concomitant presence of CAD in descending aortic aneurysm (DAA) is a setting for poor outcomes. Consideration has been given to addressing coronary disease prior to performing aortic surgery, hoping to prevent any perioperative major adverse cardiovascular events (MACE) . However, there are limited data on specific management strategies.…”

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confidence: 99%

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Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms

et al. 2015

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

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Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms

et al. 2015

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“…The HD group showed a significant lower survival both in the acute and the late phases, and the 4-year survival was a poor 60% (Fig. 2d) was poor due to the invasiveness of the surgery and the progression of the atherosclerosis 3) . It can thus be seen that there are still many problems concerning concomitant ascending aortic arch aneurysm.…”

Section: Survival Curvesmentioning

confidence: 96%

Impact of Multiarterial Atherosclerotic Disease and Atherosclerosis-related Factors on Coronary Artery Bypass Grafting

et al. 2016

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According to the annual changes in the mortality rate in Japan presented in the 2013 demographic statistics of the Ministry of Health, Labour and Welfare, the top cause of death in Japan is heart and cerebrovascular disease associated with atherosclerosis, and there is a high frequency of concomitant multiarterial atherosclerotic disease in patients diagnosed with coronary artery disease. The number of cardiovascular surgery performed on elderly patients has also been increasing, and multiarterial ath-erosclerotic disease, which increases with increasing age, cannot be ignored in the present situation. Against such a background, it is considered that coronary artery bypass grafting (CABG) on complex and 3-branch lesions in ischemic heart disease is associated with a high rate of atherosclerotic complications like carotid artery disease 1). In this study, we examined the presence of concomitant atherosclerotic disease in recent cases of CABG and the perioperative and late-phase results to investigate if multiarterial atherosclerotic disease and atherosclerosis-related factors have an impact on the results of CABG. II. Subjects and Method The subjects were 101 consecutive cases undergoing isolated CABG at our hospital between October 2011 and July 2015. Preoperatively, atherosclerosis-related factors were measured and the presence or absence of multiarterial atherosclerotic disease was confirmed by diagnostic imaging in all cases, and the impact of these factors on the results of CABG was retrospec

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“…Overall hospital mortality after total aortic arch replacement (TAR) has been declining, [1][2][3] but TAR, which requires hypothermia and prolonged cardiopulmonary bypass, remains a highly invasive procedure. Subgroups exist that may be at a surgical risk due to preoperative comorbidity, particularly patients with significant coronary artery stenosis.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Concomitant Total Aortic Arch Replacement with Coronary Artery Bypass Grafting

Yamanaka

Komiya

Tsuneyoshi

et al. 2016

ATCS

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Objective: Total aortic arch replacement is a highly invasive procedure. Here, we have investigated patient outcomes following total aortic arch replacement with or without coronary artery bypass grafting. Methods: One hundred and eighty-one patients underwent total aortic arch replacement without coronary artery bypass grafting, and 65 underwent with coronary artery bypass grafting. We compared preoperative, operative, and postoperative factors and analyzed survival outcomes. We used univariate and multivariate analyses to determine factors associated with long-term mortality. Results: Cardiopulmonary bypass and surgical times were significantly longer in the concomitant total aortic arch replacement with coronary artery bypass grafting group. Hospital mortality was 3.3% in the total aortic arch replacement group and 7.7% in the concomitant total aortic arch replacement with coronary artery bypass grafting group. Perioperative myocardial infarction was not seen in either group. There were no significant differences in mortality between the groups. Multivariate analysis revealed preoperative age, ischemic heart disease, and estimated glemerular filtration rate (eGFR) as risk factors affecting long-term mortality, whereas concomitant total aortic arch replacement with coronary artery bypass grafting was not a risk factor. Conclusion: Although patients' backgrounds should be considered, total aortic arch replacement can be concomitantly performed with coronary artery bypass grafting surgery without additional mortality risk.

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Short and Midterm Outcomes of Elective Total Aortic Arch Replacement Combined With Coronary Artery Bypass Grafting

Cited by 17 publications

References 22 publications

Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms

Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms

Impact of Multiarterial Atherosclerotic Disease and Atherosclerosis-related Factors on Coronary Artery Bypass Grafting

Outcomes of Concomitant Total Aortic Arch Replacement with Coronary Artery Bypass Grafting

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