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The Clinical Significance of Unplanned Coronary Artery Bypass Grafting in Aortic Root Replacement.
Ogami, Takuya; Serna-Gallegos, Derek; Yousef, Sarah; Brown, James A; Thoma, Floyd W; Subramaniam, Kathirvel; Gelzinis, Theresa A; Bonatti, Johannes O; Kaczorowski, David J; Yoon, Pyongsoo D; Chu, Danny; Sultan, Ibrahim.
Afiliação
  • Ogami T; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • Serna-Gallegos D; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Yousef S; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • Brown JA; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • Thoma FW; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Subramaniam K; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Gelzinis TA; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Bonatti JO; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Kaczorowski DJ; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Yoon PD; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Chu D; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Sultan I; Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: sultani@upmc.edu.
J Cardiothorac Vasc Anesth ; 38(4): 918-923, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38307738
ABSTRACT

OBJECTIVES:

Unexpected coronary artery bypass grafting (CABG) is occasionally required during aortic root replacement (ARR). However, the impact of unplanned CABG remains unknown.

DESIGN:

A single-center, retrospective observational study.

SETTING:

At university-affiliated tertiary hospital.

PARTICIPANTS:

All patients who underwent ARR from 2011 through 2022.

INTERVENTIONS:

Aortic root replacement with or without unplanned CABG. MEASUREMENTS AND MAIN

RESULTS:

A total of 795 patients underwent ARR. Among them, 131 (16.5%) underwent planned concomitant CABG, and 34 (4.3%) required unplanned CABG. The most common indication of unplanned CABG was ventricular dysfunction (33.3%), followed by disease pathology (25.6%), anatomy (15.4%), and surgical complications (10.3%). A vein graft to the right coronary artery was the most commonly performed bypass. Infective endocarditis and aortic dissection were observed in 27.8% and 12.8%, respectively. Prior cardiac surgery was seen in 40.3%. The median follow-up period was 4.3 years. Unplanned CABG was not associated with operative mortality (odds ratio [OR] 1.54, 95% CI 0.33-7.16, p = 0.58) or long-term mortality (hazard ratio 0.91, 95% CI 0.44-1.89, p = 0.81). Body surface area smaller than 1.7 was independently associated with an increased risk of unplanned CABG (OR 4.51, 95% CI 1.85-11.0, p < 0.001).

CONCLUSIONS:

Unplanned CABG occurred in 4.3% of patients during ARR, but was not associated with operative mortality or long-term mortality. A small body surface area was a factor associated with unplanned CABG.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Doença da Artéria Coronariana Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: J Cardiothorac Vasc Anesth Assunto da revista: ANESTESIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Doença da Artéria Coronariana Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: J Cardiothorac Vasc Anesth Assunto da revista: ANESTESIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos