D. Hinojosa-González, L. C. Bueno-Gutierrez, M. Salán-Gomez, Eduardo Tellez-Garcia, Isabela Ramirez-Mulhern, Diego Sepulveda-Gonzalez, D. Ramonfaur, A. Roblesgil-Medrano, E. Flores-Villalba
{"title":"混合血运重建术vs冠状动脉搭桥术治疗冠状动脉疾病:系统回顾和荟萃分析。","authors":"D. Hinojosa-González, L. C. Bueno-Gutierrez, M. Salán-Gomez, Eduardo Tellez-Garcia, Isabela Ramirez-Mulhern, Diego Sepulveda-Gonzalez, D. Ramonfaur, A. Roblesgil-Medrano, E. Flores-Villalba","doi":"10.23736/S0021-9509.22.12163-4","DOIUrl":null,"url":null,"abstract":"INTRODUCTION\nCoronary artery bypass graft is the mainstay of treatment for multivessel coronary artery disease and is superior to percutaneous coronary intervention. Combined approaches such as hybrid coronary revascularization integrate coronary artery bypass grafting with percutaneous coronary intervention during the same procedure or weeks apart. These attempt to improve surgical morbidity and long-term outcomes.\n\n\nEVIDENCE ACQUISITION\nPer PRISMA criteria, a systematic review of keywords \"Hybrid revascularization\", \"Hybrid Coronary Revascularization\", \"Surgical\", \"Surgery\", \"Treatment\", \"CABG\", \"HCR\" and \"PCI\" was conducted in PubMed, EMBASE and SCOPUS. Studies comparing this technique's performance on either single or two-stage approach against traditional multiple vessel coronary artery bypass grafting were screened and analyzed for our review.\n\n\nEVIDENCE SYNTHESIS\nTwenty-two studies totaling 6,981 participants were ultimately included for analysis. Mean differences in operative time, bleeding, ventilator time and length of stay were significantly lower in the hybrid coronary revascularization group. Odds ratios in transfusions and in-hospital myocardial infarction were also lower in the hybrid coronary revascularization group. Results for in-hospital and all-cause mortality, major adverse cardiac events (MACE), stroke, reintervention, and complete revascularization were not significantly different.\n\n\nCONCLUSIONS\nOur analysis shows hybrid coronary revascularization is a feasible alternative to traditional coronary artery bypass grafting. Short-and long-term outcomes including mortality, MACE, and postoperative morbidity are similar between both groups, while hybrid approaches are associated with decreased perioperative morbidity.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Hybrid revascularization vs coronary bypass for coronary artery disease: a systematic review and meta-analysis.\",\"authors\":\"D. Hinojosa-González, L. C. Bueno-Gutierrez, M. 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Studies comparing this technique's performance on either single or two-stage approach against traditional multiple vessel coronary artery bypass grafting were screened and analyzed for our review.\\n\\n\\nEVIDENCE SYNTHESIS\\nTwenty-two studies totaling 6,981 participants were ultimately included for analysis. Mean differences in operative time, bleeding, ventilator time and length of stay were significantly lower in the hybrid coronary revascularization group. Odds ratios in transfusions and in-hospital myocardial infarction were also lower in the hybrid coronary revascularization group. Results for in-hospital and all-cause mortality, major adverse cardiac events (MACE), stroke, reintervention, and complete revascularization were not significantly different.\\n\\n\\nCONCLUSIONS\\nOur analysis shows hybrid coronary revascularization is a feasible alternative to traditional coronary artery bypass grafting. 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Hybrid revascularization vs coronary bypass for coronary artery disease: a systematic review and meta-analysis.
INTRODUCTION
Coronary artery bypass graft is the mainstay of treatment for multivessel coronary artery disease and is superior to percutaneous coronary intervention. Combined approaches such as hybrid coronary revascularization integrate coronary artery bypass grafting with percutaneous coronary intervention during the same procedure or weeks apart. These attempt to improve surgical morbidity and long-term outcomes.
EVIDENCE ACQUISITION
Per PRISMA criteria, a systematic review of keywords "Hybrid revascularization", "Hybrid Coronary Revascularization", "Surgical", "Surgery", "Treatment", "CABG", "HCR" and "PCI" was conducted in PubMed, EMBASE and SCOPUS. Studies comparing this technique's performance on either single or two-stage approach against traditional multiple vessel coronary artery bypass grafting were screened and analyzed for our review.
EVIDENCE SYNTHESIS
Twenty-two studies totaling 6,981 participants were ultimately included for analysis. Mean differences in operative time, bleeding, ventilator time and length of stay were significantly lower in the hybrid coronary revascularization group. Odds ratios in transfusions and in-hospital myocardial infarction were also lower in the hybrid coronary revascularization group. Results for in-hospital and all-cause mortality, major adverse cardiac events (MACE), stroke, reintervention, and complete revascularization were not significantly different.
CONCLUSIONS
Our analysis shows hybrid coronary revascularization is a feasible alternative to traditional coronary artery bypass grafting. Short-and long-term outcomes including mortality, MACE, and postoperative morbidity are similar between both groups, while hybrid approaches are associated with decreased perioperative morbidity.