Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective
Objective: Concomitant coronary artery bypass grafting (CABG) and pericardiectomy (PC) can be a technically challenging operation. We sought to study the outcomes of patients undergoing concomitant PC and CABG. Methods: Between July 1983 and August 2016, 70 patients (median age, 67 years; 88% males)...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-03-01
|
| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273622003813 |
| _version_ | 1797860386553200640 |
|---|---|
| author | Vishal Khullar, MBBS Eglal Ahmed, MBBS Kevin Greason, MD Kukbin Choi, MD John Stulak, MD Katherine King, MS Mauricio Villavicencio, MD Richard Daly, MD Joseph Dearani, MD Juan Crestanello, MD Hartzell Schaff, MD |
| author_facet | Vishal Khullar, MBBS Eglal Ahmed, MBBS Kevin Greason, MD Kukbin Choi, MD John Stulak, MD Katherine King, MS Mauricio Villavicencio, MD Richard Daly, MD Joseph Dearani, MD Juan Crestanello, MD Hartzell Schaff, MD |
| author_sort | Vishal Khullar, MBBS |
| collection | DOAJ |
| description | Objective: Concomitant coronary artery bypass grafting (CABG) and pericardiectomy (PC) can be a technically challenging operation. We sought to study the outcomes of patients undergoing concomitant PC and CABG. Methods: Between July 1983 and August 2016, 70 patients (median age, 67 years; 88% males) underwent concomitant PC and CABG (PC + CABG group). Multivariable analysis was used to identify predictors of mortality. Matched patients who underwent isolated PC (PC group) were identified, and postoperative outcomes and long-term survival in the 2 groups were compared. Results: Compared with the PC group, cardiopulmonary bypass time was significantly longer in the PC + CABG group (82 minutes vs 61 minutes; P < .001). In-hospital mortality was 4% in the PC group and 7% in the PC + CABG group (P = .380). Multivariable analysis identified peripheral vascular disease (hazard ratio [HR], 2.67; 95% CI, 1.06-6.76; P = .04) as a predictor of increased morbidity or mortality and a borderline association with New York Heart Association functional classes III and IV (HR, 2.41; 95% CI, 0.99-5.86; P = .05) with increased morbidity and mortality in the PC + CABG group. Kaplan–Meier estimates demonstrated similar late mortality rates in the 2 groups at a 15-year follow-up (P = .700). Conclusions: Concomitant PC and CABG is not associated with increased morbidity or mortality compared with isolated PC. Thus, CABG should not be denied at the time of PC. |
| first_indexed | 2024-04-09T21:45:02Z |
| format | Article |
| id | doaj.art-e9b943e2e9c74486818ce0ef847faf42 |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-04-09T21:45:02Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-e9b943e2e9c74486818ce0ef847faf422023-03-25T05:15:26ZengElsevierJTCVS Open2666-27362023-03-0113178183Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspectiveVishal Khullar, MBBS0Eglal Ahmed, MBBS1Kevin Greason, MD2Kukbin Choi, MD3John Stulak, MD4Katherine King, MS5Mauricio Villavicencio, MD6Richard Daly, MD7Joseph Dearani, MD8Juan Crestanello, MD9Hartzell Schaff, MD10Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn; Address for reprints: Vishal Khullar, MBBS, Department of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905.Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDivision of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnObjective: Concomitant coronary artery bypass grafting (CABG) and pericardiectomy (PC) can be a technically challenging operation. We sought to study the outcomes of patients undergoing concomitant PC and CABG. Methods: Between July 1983 and August 2016, 70 patients (median age, 67 years; 88% males) underwent concomitant PC and CABG (PC + CABG group). Multivariable analysis was used to identify predictors of mortality. Matched patients who underwent isolated PC (PC group) were identified, and postoperative outcomes and long-term survival in the 2 groups were compared. Results: Compared with the PC group, cardiopulmonary bypass time was significantly longer in the PC + CABG group (82 minutes vs 61 minutes; P < .001). In-hospital mortality was 4% in the PC group and 7% in the PC + CABG group (P = .380). Multivariable analysis identified peripheral vascular disease (hazard ratio [HR], 2.67; 95% CI, 1.06-6.76; P = .04) as a predictor of increased morbidity or mortality and a borderline association with New York Heart Association functional classes III and IV (HR, 2.41; 95% CI, 0.99-5.86; P = .05) with increased morbidity and mortality in the PC + CABG group. Kaplan–Meier estimates demonstrated similar late mortality rates in the 2 groups at a 15-year follow-up (P = .700). Conclusions: Concomitant PC and CABG is not associated with increased morbidity or mortality compared with isolated PC. Thus, CABG should not be denied at the time of PC.http://www.sciencedirect.com/science/article/pii/S2666273622003813pericardiectomycoronary artery bypass graftingpericarditis |
| spellingShingle | Vishal Khullar, MBBS Eglal Ahmed, MBBS Kevin Greason, MD Kukbin Choi, MD John Stulak, MD Katherine King, MS Mauricio Villavicencio, MD Richard Daly, MD Joseph Dearani, MD Juan Crestanello, MD Hartzell Schaff, MD Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective JTCVS Open pericardiectomy coronary artery bypass grafting pericarditis |
| title | Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective |
| title_full | Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective |
| title_fullStr | Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective |
| title_full_unstemmed | Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective |
| title_short | Impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy: A 33-year experienceCentral MessagePerspective |
| title_sort | impact of concomitant coronary artery bypass grafting on postoperative outcomes in patients undergoing pericardiectomy a 33 year experiencecentral messageperspective |
| topic | pericardiectomy coronary artery bypass grafting pericarditis |
| url | http://www.sciencedirect.com/science/article/pii/S2666273622003813 |
| work_keys_str_mv | AT vishalkhullarmbbs impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT eglalahmedmbbs impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT kevingreasonmd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT kukbinchoimd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT johnstulakmd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT katherinekingms impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT mauriciovillavicenciomd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT richarddalymd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT josephdearanimd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT juancrestanellomd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective AT hartzellschaffmd impactofconcomitantcoronaryarterybypassgraftingonpostoperativeoutcomesinpatientsundergoingpericardiectomya33yearexperiencecentralmessageperspective |