Journal of Cardiac Surgery最新文献

{"title":"Benefits of On-X Mitral Valve Replacement in Cases of Infective Endocarditis","authors":"Manabu Shiraishi,&nbsp;Hiroki Arai,&nbsp;Shigeto Tokunaga,&nbsp;Kengo Teshima,&nbsp;Naoyuki Kimura,&nbsp;Atsushi Yamaguchi","doi":"10.1155/2024/3482523","DOIUrl":"10.1155/2024/3482523","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Mitral valve replacement (MVR) is necessary in cases of severe infective endocarditis (IE). Because the On-X valve is expected to be effective in reducing prosthesis-associated turbulent blood flow, we investigated the hemodynamic efficacy of the On-X valve when used for MVR in cases of mitral valve IE. <i>Methods</i>. We compared postoperative outcomes between two groups of patients who underwent MVR for IE: 13 given an On-X valve and 27 given an SJM valve. <i>Results</i>. There were no in-hospital deaths. Late death occurred in 6 cases, all in the SJM group (<i>P</i> = 0.1520). The incidence of late postoperative atrial fibrillation was relatively low in the On-X group (1 case vs. 10 cases, <i>P</i> = 0.068). Univariate analysis showed an association between the effective orifice area and postoperative atrial fibrillation. The effective orifice area and indexed effective orifice area were significantly larger in the On-X group at 2.8 ± 0.7 cm² vs. 2.2 ± 0.5 cm² (<i>P</i> = 0.007) and 1.8 ± 0.5 cm²/m² vs. 1.4 ± 0.4 cm² (<i>P</i> = 0.003), respectively. <i>Conclusions</i>. The suggested reduction in left atrial load attributed to the use of the On-X valve in MVR for IE may reduce the incidence of postoperative atrial fibrillation.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3482523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Center Experience in Low Ejection Fraction Coronary Artery Bypass Surgery","authors":"Amber Malhotra,&nbsp;Md Anamul Islam,&nbsp;Giuseppe Tavilla,&nbsp;Ramachandra Reddy,&nbsp;Thomas d’Amato,&nbsp;Sameer Gupta,&nbsp;Mustafa Baldawi","doi":"10.1155/2024/8827313","DOIUrl":"10.1155/2024/8827313","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Coronary artery bypass graft (CABG) in patients with an ejection fraction (EF) ≤ 35% predisposes them to higher complications and mortality risks. Given the usually compromised status of other end organs in low EF patients, ONCAB, involving cardiopulmonary bypass (CPB) and aortic cross-clamping, might intuitively pose more complications than OPCAB. <i>Objective</i>. To explore short- and long-term outcomes between ONCAB and OPCAB procedures in patients with EF ≤ 35%. <i>Methods</i>. A retrospective and observational analysis was conducted in 196 patients with EF ≤ 35% who underwent ONCAB (<i>n</i> = 58) or OPCAB (<i>n</i> = 138) procedures at a single center between January 2015 and May 2023. Baseline characteristics were well matched using the stabilized inverse probability treatment weighted matching technique. <i>Results</i>. After matching, ONCAB and OPCAB had comparable 30-day mortality and 30-day cardiac mortality. OPCAB exhibited significantly shorter length of hospital and ICU stays, with a trend towards more discharges to home. Rates of composite complication and its individual components such as acute kidney injury, reoperation bleeding, stroke, pneumonia, GI disease, and atrial fibrillation were similar between the two groups. Rates of sepsis, liver dysfunction, and blood transfusion were significantly lower in the OPCAB group. As assessed by EF and LVDD, neither procedure showed superiority in improving cardiac function. Median follow-up time was 4.9 (interquartile range: 2.1–7.2) years. After matching, long-term overall survival (1, 3, 7 years) and cardiac mortality rates were comparable between OPCAB and ONCAB. Cumulative rates of cardiac arrest, heart failure, myocardial infarction (MI), atrial fibrillation (Afib), renal disease, and readmission (overall and cardiac) at 7 years were similar. <i>Conclusion</i>. This study demonstrates comparable short-term and long-term outcomes between ONCAB and OPCAB in patients with reduced EF, with OPCAB favoring faster recovery. OPCAB appears as a safer and equally effective option for low EF CABG patients. Larger samples and longer follow-ups are needed for conclusive clinical evidence.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8827313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139776590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 in the Age of Computer-Assisted Surgery: Cost and Effectiveness Comparison between Robotic and Minimally Invasive Mitral Valve Surgery in a Single-Center Experience","authors":"Laura Giroletti,&nbsp;Daniele Salvi,&nbsp;Lorenzo Peluso,&nbsp;Giovanni Albano,&nbsp;Ascanio Graniero,&nbsp;Valentina Grazioli,&nbsp;Nicola Villari,&nbsp;Claudio Roscitano,&nbsp;Matteo Parrinello,&nbsp;Ettore Lanzarone,&nbsp;Alfonso Agnino","doi":"10.1155/2024/2453937","DOIUrl":"10.1155/2024/2453937","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. We conducted a cost and effectiveness analysis comparing robotic vs minimally invasive mitral valve surgery (RMVS vs MIMVS). The aim was to assess whether the higher cost of the robotic technique could be mitigated by the clinical advantages. <i>Methods</i>. We included 118 patients undergoing RMVS and 233 patients undergoing MIMVS. Initially, RMVS experience was developed during the COVID-19 pandemic. A propensity score matching analysis was performed. Postoperative outcomes and cost of care were compared. <i>Results</i>. RMVS patients had significantly shorter ICU and hospital lengths of stay. They also had a significantly earlier return to home. The cost of the total hospitalization and healthcare services were also significantly lower. <i>Conclusion</i>. Shorter hospitalization and lower cost of postoperative healthcare services may mitigate the initial investment cost to purchase and maintain the robot. These benefits are all the more relevant considering that several RMVS treatments were carried out during the COVID-19 pandemic.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2453937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139838283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Open-Heart Surgery Pain Relief Using Transversus Thoracic Plane Blocks","authors":"Xiuli Ye,&nbsp;Yun Zou,&nbsp;Yijian Chen,&nbsp;Guiming Huang,&nbsp;Ruiming Deng,&nbsp;Weidong Liang,&nbsp;Ruipeng Zhong","doi":"10.1155/2024/9910242","DOIUrl":"10.1155/2024/9910242","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Severe postoperative pain is commonly reported following open-heart surgery, necessitating the implementation of effective pain management strategies to facilitate patient recovery. The benefits of the transverse thoracic muscle plane (TTMP) block for open-heart surgery remain unclear. Therefore, a meta-analysis was conducted to systematically evaluate the effect of TTMP on postoperative analgesia and recovery in patients undergoing open-heart surgery. <i>Methods</i>. A computer search was performed in PubMed, Cochrane, Embase, CNKI, and Wangfang databases. The primary outcome was 24-hour postoperative opioid consumption, and the secondary outcomes were 12- and 24-hour postoperative resting and motor pain scores, time of first analgesia demand, extubation time, length of stay in the intensive care unit (ICU), time of first feces, incidence of nausea and vomiting, and length of hospitalization. <i>Results</i>. Thirteen randomized controlled trials (RCTs) involving a total of 766 patients were included in this meta-analysis. Compared with the control group, the TTMP group showed a significant reduction in opioid consumption within 24 h postoperatively (mean difference = −41.88 mg; 95% confidence interval: −51.99, −31.77; <i>p</i> &lt; 0.001; and <i>I</i>² = 98%). However, the 12- and 24-hour postoperative resting and moment VAS pain scores were significantly lower in the TTMP group. In addition, the TTMP group had a longer time of first analgesic demand; shorter endotracheal intubation time, ICU stay duration, time of first feces, and length of hospital stay; and a lower incidence of nausea and vomiting. <i>Conclusions</i>. Perioperative TTMP block can reduce the use of opioids in patients undergoing open-heart surgery for 24 h postoperatively, decrease the early postoperative pain scores, prolong the time of first analgesic demand, shorten the time of extubation and the length of ICU stay and hospitalization, and reduce the incidence of nausea and vomiting, which are all conducive to the recovery of patients. <i>Registration</i>. This trial is registered with PROSPERO database (CRD42022312435).</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9910242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139854757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Risk Prediction Model for Adverse Events after Surgical Valve Replacement","authors":"Liyou Lian,&nbsp;Hongxia Yao,&nbsp;Rujie Zheng,&nbsp;Chen Chen","doi":"10.1155/2024/2190566","DOIUrl":"10.1155/2024/2190566","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Although several risk-predictive models for patients undergoing surgical valve replacement (SVR) have been published, reports on composite endpoints of adverse events in these patients are limited. This study aimed to establish a novel, easy-to-use prognostic prediction model of composite endpoints in patients following SVR. <i>Methods</i>. According to the inclusion criteria, patients with successful SVR were enrolled. Adverse events, including heart failure hospitalization, stroke, major bleeding, uncontrolled infection, secondary surgery, postoperative arrhythmia, and all-cause mortality during follow-up, were tracked. All datasets were randomly divided into the derivation and validation cohorts at a ratio of 7 to 3. Logistic regression analysis was used to screen for independent predictors and construct a nomogram for adverse events. We further presented a calibration curve and decision curve analysis for evaluating prediction models. <i>Results</i>. According to the multivariate logistic regression analyses, three variables were selected for the final predictive model, including platelet-to-lymphocyte ratio, diabetes mellitus, and albumin. A nomogram was then constructed to present the results. The C-index of the model was 0.73 (95% confidence interval: 0.65–0.81) for the derivation cohort and 0.75 (95% confidence interval: 0.64–0.86) for the validation cohort. The calibration curve demonstrated that the results of the nomogram agreed with actual observations (Brier score = 0.09). <i>Conclusions</i>. We developed an effective nomogram to predict the occurrence of composite adverse events in patients following SVR. This model could be used to evaluate the mid-term risks of adverse events as well as provide clinicians and patients with a basis for decision-making.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2190566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Circulatory Support in Cases of Acute DeBakey Type I Aortic Dissection: A Novel Arterial Cannulation Approach and Its Effects on Perfusion and Minimizing Complications","authors":"Xin Deng,&nbsp;Peiyun Zhang,&nbsp;Xueting Fan,&nbsp;Chengming Ding,&nbsp;Yaoguang Feng,&nbsp;Zhengwen Lei","doi":"10.1155/2024/8904638","DOIUrl":"10.1155/2024/8904638","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Proposing a novel arterial cannulation technique for acute DeBakey type I aortic dissection with severe aortic arch and branch involvement to enhance CPB effectiveness and reduce organ malperfusion complications. <i>Methods</i>. The technique involves retrograde insertion of an arterial perfusion tube into the aortic arch through the left common carotid artery. Extracorporeal circulation is established, and total aortic arch replacement with deep hypothermic systemic circulation and a frozen elephant trunk stent placement are performed to restore lower body perfusion. <i>Results</i>. Six patients with severe aortic arch and branch involvement underwent the new arterial cannulation technique. All patients had smooth postoperative recoveries without significant complications. <i>Conclusion</i>. The novel arterial cannulation technique shows promise in managing acute DeBakey type I aortic dissection with extensive vascular involvement, reducing complications, and enhancing patient outcomes. Further validation with a larger patient cohort is needed to confirm its effectiveness and safety. If successful, this technique could become a valuable addition to treatment strategies for improved outcomes.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8904638","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139527219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remodeling on Lateral Side of Posterior Mitral Leaflet in Recurrent Mitral Regurgitation after Mitral Annuloplasty for Patients with Atrial Functional Mitral Regurgitation","authors":"Shusuke Imaoka,&nbsp;Masashi Kawamura,&nbsp;Daisuke Yoshioka,&nbsp;Takuji Kawamura,&nbsp;Ai kawamura,&nbsp;Ryohei Matsuura,&nbsp;Yusuke Misumi,&nbsp;Shigeru Miyagawa","doi":"10.1155/2024/3481135","DOIUrl":"10.1155/2024/3481135","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The high recurrence rate of mitral regurgitation (MR) in patients with atrial functional mitral regurgitation (AFMR) who underwent mitral annuloplasty (MAP) is reported. However, the mechanism of recurrence is not fully understood and appropriate surgical intervention remains unknown. Herein, we reviewed patients with AFMR who underwent MAP at our institution and investigated the preoperative geometric characteristics of the mitral valve in terms of MR recurrence after surgery. <i>Methods</i>. We retrospectively evaluated 20 patients with AFMR who underwent MAP between 2010 and 2022. The mean follow-up period was 3.2 ± 2.3 years. Preoperative three-dimensional transesophageal echocardiography (3D TEE) was available for all patients, and geometric analysis of the mitral valve was performed using the Philips Q-Lab software. <i>Results</i>. MR recurred in six patients. The rates of freedom from MR recurrence were 79% and 57% at one and three years, respectively. The lateral portion of the posterior mitral leaflet (PML) in patients with recurrent MR was longer and thicker than that in patients without recurrent MR (length of P1; 10 ± 3 vs. 15 ± 5 mm, <i>p</i> &lt; 0.01, length of P2; 11 ± 4 vs. 14 ± 4 mm, <i>p</i> = 0.23, length of P3; 8 ± 3 vs. 10 ± 3 mm, <i>p</i> = 0.13). <i>Conclusions</i>. Patients with remodeling of the lateral portion of PML tended to have recurrent MR after MAP. This factor could indicate progressive remodeling, and MAP alone may not be a sufficient intervention for these patients.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3481135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139445505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Donor Thyroid Hormone Supplementation on Heart Transplant Recipient Survival","authors":"David Blitzer,&nbsp;David A. Baran,&nbsp;Seth Lirette,&nbsp;Matthew Kutcher,&nbsp;Asim Mohammed,&nbsp;Hannah Copeland","doi":"10.1155/2024/6368443","DOIUrl":"10.1155/2024/6368443","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. The use of thyroid hormone supplementation (THS) for donor optimization has not been standardized and remains an area of academic investigation and clinical interest. The purpose of this study is to investigate the impact of THS supplementation on heart transplant recipient outcomes. <i>Methods</i>. Adult heart transplant recipients in the UNOS database recorded from January 1, 2000 to June 30, 2022 formed the study cohort. Simple comparisons were made with <i>t</i>-tests or chi-squared tests. Logistic regression models were used to predict 30 day and 1 year survival. Accelerated failure time models were employed to analyze time to death and time to rejection. <i>Results</i>. The cohort consisted of 46,542 heart transplants, of which 28,911 (62%) received THS prior to organ procurement. In adjusted models, donor THS was associated with a reduction of 11% in the odds of death within 30 days (OR = 0.89; <i>p</i> = 0.048); however, this relationship did not extend to one year post-transplant survival (OR = 1.00; <i>p</i> = 0.968). After a sex-based analysis, 30-day survival benefit was seen only in male-to-male donor-recipient pairings (OR for death = 0.82; <i>p</i> = 0.007). Overall survival and post-transplant rejection was also improved in the male-to-male group (HR = 0.94; <i>p</i> = 0.002 and HR = 0.96; <i>p</i> = 0.048) and the female-to-female group (HR = 0.87; <i>p</i> = 0.003 and HR = 0.90; <i>p</i> = 0.013). There was no associated survival benefit with THS in sex mismatched groups. <i>Conclusion</i>. THS in donors is associated with improved 30-day post-transplant survival and overall survival after OHT in sex-matched donor-recipient pairs. Further study is warranted.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6368443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Surgical Aortic Valve Size and Choices in the Transcatheter Aortic Valve Replacement Era","authors":"Zachary M Gertz, Raymond J. Strobel, Alex M. Wisniewski, Clifford E. Fonner, Alan Speir, N. Teman, Mohammed Quader","doi":"10.1155/2023/5537595","DOIUrl":"https://doi.org/10.1155/2023/5537595","url":null,"abstract":"Objective. The adoption of transcatheter aortic valve replacement (TAVR) has changed the profile of patients referred for surgical aortic valve replacement (SAVR) and drawn more attention to valve sizing and durability. We examined the influence of TAVR on SAVR practice. Methods. Using a statewide database, we evaluated all isolated SAVRs, categorized into three eras: pre-TAVR (2008 to 2011), early TAVR (2012 to 2015), and current-TAVR (2016 to 2022). The primary outcomes of interest were changes in prosthetic valve size and the percentage of mechanical valves used between time periods. Results. There were 6,445 patients included. SAVR volume declined in the current era. Valve size increased over time. In the pre-TAVR era, 41% of patients received a valve smaller than 23 mm, which declined to 33% in the early TAVR era, then to 22% in the current era (p < 0.001 for all). The year of surgery was significantly associated with larger valve selection even after controlling for patient characteristics. Annular enlargement rose in the current-TAVR era (p < 0.001). The use of mechanical valves rose in the current era (p < 0.001 compared to early TAVR). Regression analysis showed that the year of surgery was not predictive of mechanical valve use, suggesting that changes in practice were driven by patient characteristics. Conclusion. Surgical valve choice since the adoption of TAVR has changed, with less frequent use of smaller valves. Increases in mechanical valve usage are likely a reflection of changing patient population.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Total Arterial Revascularization Compared to Conventional Coronary Artery Bypass Graft in Patients with Multivessel Disease and Left Ventricular Dysfunction","authors":"Zhi-qin Lin, Zheng Xu, Liang-wan Chen, X. Dai","doi":"10.1155/2023/5557796","DOIUrl":"https://doi.org/10.1155/2023/5557796","url":null,"abstract":"Background. Multivessel coronary artery disease (CAD) and left ventricular dysfunction (LVD) present challenges in CABG. We aimed to compare early outcomes of total arterial revascularization (TAR) versus conventional CABG in this high-risk population. Methods. This was a retrospective cohort study based on a single-center registry of patients who underwent isolated CABG for multivessel CAD and LVD between January 2014 and December 2022. Primary outcome was in-hospital mortality. Secondary outcomes were early complications, graft patency rate at 3 months, readmission rate within 6 months, and freedom from angina rate within 6 months. Results. A total of 112 cases were included in this study; 52 patients for TAR and 60 patients for conventional CABG. Both groups had comparable baselines and operative profiles. In-hospital mortality was similar between TAR and conventional CABG (2 deaths, 3.85% vs 4 deaths, 6.67%, \u0000 \u0000 p\u0000 \u0000  = 0.810). TAR had shorter ICU (3.5 vs 5 days, \u0000 \u0000 p\u0000 \u0000  = 0.016) and hospital stay (10.5 vs 12 days, \u0000 \u0000 p\u0000 \u0000  = 0.007). Other postoperative complications were similar. At 3 months, TAR had superior graft patency (91.7% vs 83.7%, \u0000 \u0000 p\u0000 \u0000  = 0.034) and lower 6-month readmission (TAR: 2/50, 4.0% vs. CR: 10/56, 17.9%, \u0000 \u0000 p\u0000 \u0000  = 0.024). Freedom from angina rate within 6 months was similar between the two groups (TAR: 43/50, 86.0% vs. CR: 42/56, 75.0%, \u0000 \u0000 p\u0000 \u0000  = 0.240). Conclusion. Our findings suggest that TAR may offer benefits in terms of shorter hospital stays, higher early graft patency, and lower readmission rates for patients with multivessel CAD and LVD. However, further research, particularly large-scale, randomized trials with longer follow-up periods, are needed to fully understand the long-term clinical outcomes and confirm these promising early results.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}