Current trends in selection of conduits for coronary artery bypass grafting

AbstractCoronary artery disease (CAD) is one of the leading causes of mortality in the world. The most advanced forms of CAD are usually treated by means of coronary artery bypass grafting (CABG). The selection of the appropriate vessels as aortocoronary conduits is of paramount importance. The internal thoracic artery (ITA) or the great saphenous vein (SV) are often harvested. Furthermore, epigenetic processes have been recently associated with atherosclerosis, hypertension, and heart failure, and post-translational histone processes may play a key role in understanding the genetic predisposition of vessels to vascular diseases.In the experiment performed, the transcript levels of JHDM1D, PHF8, and HDAC 1-3 in SV and ITA used for CABG procedures with RT-qPCR were examined. Total RNA was isolated by the method of Chomczyński and Sachi. RNA samples were reverse transcribed into cDNA using a commercial kit. The determination of the level of the transcripts of the mentioned genes was performed using the Light Cycler® 96 Real-Time PCR kit. Our analyzes confirmed that the studied genes related to post-translational modifications of histones are expressed in SV and ITA. In the saphenous vein, the expression of each of the individual genes was higher. The most considerable difference in transcript levels was recorded for HDAC1 and the smallest difference in expression for HDAC2.Our research suggests that more processes related to histone demethylation and acetylation occur in the saphenous vein, which may affect the selection of a vessel for CABG, but this research requires more research and additional analysis.Running title: Histone regulating gene expression in common coronary artery bypass graft vessels

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SELECTION OF THE MODE OF CARDIOPULMONAY BYPASS IN AGED AND GERIATRIC PATIENTS WITH CORONARY ARTERY BYPASS GRAFTING

Bulletin of Problems Biology and Medicine ◽

10.29254/2077-4214-2019-1-2-149-142-146 ◽

2019 ◽

Vol 1 (2) ◽

pp. 142

Author(s):

S. R. Druzhyna ◽

S. R. Loskutov ◽

S. R. Maruniak

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Geriatric Patients ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Selection Of

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Impact of previous coronary artery bypass grafting in patients presenting with an acute coronary syndrome: Current trends and clinical implications

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872619899309 ◽

2020 ◽

Vol 9 (7) ◽

pp. 731-740

Author(s):

Joana M Ribeiro ◽

Rogério Teixeira ◽

Alexandrina Siserman ◽

Luís Puga ◽

João Lopes ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Coronary Syndrome ◽

Current Trends ◽

One Year

Background: Among patients presenting with an acute coronary syndrome, those with previous coronary artery bypass grafting are a particular subset. Aims: The purpose of this study was to investigate the prognostic impact of previous coronary artery bypass grafting in acute coronary syndrome patients and to identify the current trends in their clinical management. Methods: We performed a cohort analysis of patients prospectively enrolled in the Portuguese Registry of acute coronary syndrome between 2010–2019 with known previous coronary artery bypass grafting status. The co-primary endpoints were in-hospital and one-year mortality. Results: A total of 19,334 (962 coronary artery bypass grafting and 18,372 non-coronary artery bypass grafting) and 9402 (479 coronary artery bypass grafting and 8923 non-coronary artery bypass grafting) patients were included in the analyses of in-hospital and mid-term outcomes, respectively. Coronary artery bypass grafting patients were older and had a higher incidence of comorbidities. They were less likely to undergo invasive angiography (74.9 vs 84.6%, p<0.001), but were equally likely to receive dual antiplatelet therapy (91.0 vs 90.8%, p=0.823). In-hospital mortality was similar between groups (3.6 vs 3.4%, p=0.722). Unadjusted one-year mortality was higher in the coronary artery bypass grafting group (hazard ratio 1.48, 95% confidence interval 1.09–2.01, p=0.012), but similar in both groups after propensity-matching and multivariate analysis (hazard ratio 0.63, 95% confidence interval 0.37–1.09, p=0.098). Conclusions: Among patients with acute coronary syndrome, a previous history of coronary artery bypass grafting was associated with a high burden of comorbidities and a high-risk profile but was not an independent predictor of adverse events. Treatment decisions should be made on a case-by-case basis, and should not be based on previous coronary artery bypass grafting status alone.

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The selection of conduits for coronary artery bypass surgery

State of the Art Surgical Coronary Revascularization ◽

10.1093/med/9780198758785.003.0039 ◽

2021 ◽

pp. 233-236

Author(s):

Mario Gaudino ◽

Martin Misfeld ◽

R. John ◽

L. Brereton

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Clinical Characteristics ◽

Artery Bypass ◽

The United States ◽

Complete Revascularization ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Selection Of

Coronary artery bypass grafting is the most common adult cardiac surgery operation performed in the United States and probably worldwide. Complete revascularization and excellent patency of the implanted grafts are the primary aims of coronary artery bypass grafting; individualized selection of conduits appropriate for the specific coronary anatomy and clinical characteristics of each patient is key to achieving this goal.

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