Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality
Aim. To compare the immediate outcomes and 30-day mortality of in situ bimammary coronary artery bypass grafting (CABG) using two internal thoracic arteries (ITAs) versus a composite grafting.Material and methods. We searched PubMed, Google Scholar, and Web of Science databases for a period from 199...
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«FIRMA «SILICEA» LLC
2021-07-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4504 |
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| author | S. T. Enginoev D. A. Kondratyev G. M. Magomedov S. S. Ekimov A. A. Zenkov А. P. Motreva B. K. Kadyraliev I. I. Chernov D. G. Tarasov |
| author_facet | S. T. Enginoev D. A. Kondratyev G. M. Magomedov S. S. Ekimov A. A. Zenkov А. P. Motreva B. K. Kadyraliev I. I. Chernov D. G. Tarasov |
| author_sort | S. T. Enginoev |
| collection | DOAJ |
| description | Aim. To compare the immediate outcomes and 30-day mortality of in situ bimammary coronary artery bypass grafting (CABG) using two internal thoracic arteries (ITAs) versus a composite grafting.Material and methods. We searched PubMed, Google Scholar, and Web of Science databases for a period from 1990 to 2020 for studies comparing in situ bimammary CABG versus composite grafts. The PICO search model was used as follows: patient, intervention, comparison, outcomes. The data were derived by two independent researchers and subjected to a meta-analysis using a random effect.Results. A total of 10 studies were selected for this meta-analysis. Of these, there were 2 randomized controlled trials (n=705), 4 observational propensity score matching studies (n=4267) and 4 unadjusted observational studies (n=3517). With both ITA in situ surgery, fewer distal anastomoses are applied (MD=0,23; 95% confidence interval (CI), 0,15-0,32; p<0,001). But there was no significant difference n myocardial ischemia between groups (3 min with 95% CI, -3,23-9,79; p=0,32). There was no significant difference between groups in the incidence of perioperative stroke (hazard ratio (HR)=0,5; 95% CI; 0,63-1,74; p=0,85 ), myocardial infarction (HR=1,1; 95% CI 0,66-1,85; p=0,71), mediastinitis (HR=0,86; 95% CI; 0,62-1,20; p=0,38), resternotomy due to bleeding (HR=1,29; 95% CI, 0,75-2,21; p=0,36), acute renal injury (HR=1,24; 95% CI, 0, 84-1,84; p=0,29), inhospital mortality (HR=1,08; 95% CI, 0,67-1,75; p=0,75) and 30-day mortality (HR=1,19; 95% CI, 0,81-1,75; p=0,38), but the incidence of postoperative atrial fibrillation was significantly lower in the group with both ITA in situ surgery (RR=1,23 with 95% CI 1,04-1,44; p=0,01).Conclusion. With composite bimammary CABG, more distal anastomoses with ITA were applied, while the time of myocardial ischemia did not differ between the groups. We found no significant difference in the incidence of perioperative myocardial infarction, stroke, mediastinitis, acute renal injury, resternotomy due to bleeding, inhospital mortality, and 30-day mortality. But at the same time, the HR for postoperative atrial fibrillation was significantly lower in the group with both ITA in situ surgery. |
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| institution | Directory Open Access Journal |
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| language | Russian |
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| publishDate | 2021-07-01 |
| publisher | «FIRMA «SILICEA» LLC |
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| series | Российский кардиологический журнал |
| spelling | doaj.art-399ec0ac59684295bdd5cbad90dfd5792023-03-29T21:23:38Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-07-01262S10.15829/1560-4071-2021-45043279Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortalityS. T. Enginoev0D. A. Kondratyev1G. M. Magomedov2S. S. Ekimov3A. A. Zenkov4А. P. Motreva5B. K. Kadyraliev6I. I. Chernov7D. G. Tarasov8Federal Center for Cardiovascular Surgery; Astrakhan State Medical UniversityFederal Center for Cardiovascular SurgeryFederal Center for Cardiovascular SurgeryFederal Center for Cardiovascular SurgeryFederal Center for Cardiovascular SurgeryFederal Center for Cardiovascular SurgeryS.G. Sukhanov Federal Center for Cardiovascular Surgery; E.A. Wagner Perm State Medical UniversityFederal Center for Cardiovascular SurgeryFederal Center for Cardiovascular SurgeryAim. To compare the immediate outcomes and 30-day mortality of in situ bimammary coronary artery bypass grafting (CABG) using two internal thoracic arteries (ITAs) versus a composite grafting.Material and methods. We searched PubMed, Google Scholar, and Web of Science databases for a period from 1990 to 2020 for studies comparing in situ bimammary CABG versus composite grafts. The PICO search model was used as follows: patient, intervention, comparison, outcomes. The data were derived by two independent researchers and subjected to a meta-analysis using a random effect.Results. A total of 10 studies were selected for this meta-analysis. Of these, there were 2 randomized controlled trials (n=705), 4 observational propensity score matching studies (n=4267) and 4 unadjusted observational studies (n=3517). With both ITA in situ surgery, fewer distal anastomoses are applied (MD=0,23; 95% confidence interval (CI), 0,15-0,32; p<0,001). But there was no significant difference n myocardial ischemia between groups (3 min with 95% CI, -3,23-9,79; p=0,32). There was no significant difference between groups in the incidence of perioperative stroke (hazard ratio (HR)=0,5; 95% CI; 0,63-1,74; p=0,85 ), myocardial infarction (HR=1,1; 95% CI 0,66-1,85; p=0,71), mediastinitis (HR=0,86; 95% CI; 0,62-1,20; p=0,38), resternotomy due to bleeding (HR=1,29; 95% CI, 0,75-2,21; p=0,36), acute renal injury (HR=1,24; 95% CI, 0, 84-1,84; p=0,29), inhospital mortality (HR=1,08; 95% CI, 0,67-1,75; p=0,75) and 30-day mortality (HR=1,19; 95% CI, 0,81-1,75; p=0,38), but the incidence of postoperative atrial fibrillation was significantly lower in the group with both ITA in situ surgery (RR=1,23 with 95% CI 1,04-1,44; p=0,01).Conclusion. With composite bimammary CABG, more distal anastomoses with ITA were applied, while the time of myocardial ischemia did not differ between the groups. We found no significant difference in the incidence of perioperative myocardial infarction, stroke, mediastinitis, acute renal injury, resternotomy due to bleeding, inhospital mortality, and 30-day mortality. But at the same time, the HR for postoperative atrial fibrillation was significantly lower in the group with both ITA in situ surgery.https://russjcardiol.elpub.ru/jour/article/view/4504bimammary coronary artery bypass graftingcoronary artery bypass graftingmyocardial revascularization |
| spellingShingle | S. T. Enginoev D. A. Kondratyev G. M. Magomedov S. S. Ekimov A. A. Zenkov А. P. Motreva B. K. Kadyraliev I. I. Chernov D. G. Tarasov Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality Российский кардиологический журнал bimammary coronary artery bypass grafting coronary artery bypass grafting myocardial revascularization |
| title | Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality |
| title_full | Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality |
| title_fullStr | Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality |
| title_full_unstemmed | Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality |
| title_short | Systematic review and meta-analysis of <i>in situ</i> versus composite bimammary coronary artery bypass grafting: immediate outcomes and 30-day mortality |
| title_sort | systematic review and meta analysis of i in situ i versus composite bimammary coronary artery bypass grafting immediate outcomes and 30 day mortality |
| topic | bimammary coronary artery bypass grafting coronary artery bypass grafting myocardial revascularization |
| url | https://russjcardiol.elpub.ru/jour/article/view/4504 |
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