Off-Pump Right Coronary Artery Bypass With Saphaneous Vein or In-Situ Right Internal Thoracic Artery

2010 ◽  
Vol 89 (3) ◽  
pp. 717-722 ◽  
Author(s):  
Gijong Yi ◽  
Young-Nam Youn ◽  
Suk-Won Song ◽  
Kyung-Jong Yoo
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Right Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Off Pump ◽  
Right Internal Thoracic Artery

Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Japan cardiovascular surgery database 2. Isolated coronary artery bypass surgery

2021 ◽  
pp. 021849232098149
Author(s):  
Aya Saito ◽  
Hiraku Kumamaru ◽  
Noboru Motomura ◽  
Hiroaki Miyata ◽  
Shinichi Takamoto
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Clinical Results ◽  
Graft Material ◽  
Off Pump ◽  
Left Anterior Descending Artery ◽  
Pump Coronary Artery Bypass

Background Clinical outcomes (as national clinical data) of isolated coronary artery bypass grafting have been successively reported, based on data registered in the Japan Cardiovascular Surgery Database, since 2013. In this study, we analysed the clinical results of isolated coronary artery bypass from 2017 to 2018 as a biannual report. Methods Data from the Japan Cardiovascular Surgery Database on isolated coronary artery bypass performed in 2017 and 2018 were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery. Results Isolated off-pump coronary artery bypass was performed in 54.6% ( n = 14,684) of all coronary artery bypass cases ( n = 26,913), and graft material for the left anterior descending artery was the left internal thoracic artery in 76.4% of cases and the right internal thoracic artery in 19.0% of cases. Operative mortality was 1.5% in elective cases (on-pump coronary artery bypass 1.9% and off-pump 1.2%, p < 0.001), 7.4% in emergency cases (on-pump 10.2% and off-pump 4.3%, p < 0.001), and 2.5% overall. Postoperative morbidity was generally lower in off-pump coronary artery bypass. The severity of surgery with expected mortality, evaluated using JapanSCORE II, is increasing every year. Conclusions Our findings suggest that short-term operative results for isolated coronary artery bypass are stable, and operative candidates are shifting to higher-risk patients.

scholarly journals Angiographic Patency of Coronary Artery Bypass Conduits: A Network Meta‐Analysis of Randomized Trials

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Mario Gaudino ◽  
Irbaz Hameed ◽  
N. Bryce Robinson ◽  
Yongle Ruan ◽  
Mohamed Rahouma ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Randomized Trials ◽  
Internal Thoracic Artery ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Gastroepiploic Artery ◽  
Graft Occlusion ◽  
Right Internal Thoracic Artery

Background Several randomized trials have compared the patency of coronary artery bypass conduits. All of the published studies, however, have performed pairwise comparisons and a comprehensive evaluation of the patency rates of all conduits has yet to be published. We set out to investigate the angiographic patency rates of all conduits used in coronary bypass surgery by performing a network meta‐analysis of the current available randomized evidence. Methods and Results A systematic literature search was conducted for randomized controlled trials comparing the angiographic patency rate of the conventionally harvested saphenous vein, the no‐touch saphenous vein, the radial artery (RA), the right internal thoracic artery, or the gastroepiploic artery. The primary outcome was graft occlusion. A total of 4160 studies were retrieved of which 14 were included with 3651 grafts analyzed. The weighted mean angiographic follow‐up was 5.1 years. Compared with the conventionally harvested saphenous vein, both the RA (incidence rate ratio [IRR] 0.54; 95% CI, 0.35–0.82) and the no‐touch saphenous vein (IRR 0.55; 95% CI, 0.39–0.78) were associated with lower graft occlusion. The RA ranked as the best conduit (rank score for RA 0.87 versus 0.85 for no‐touch saphenous vein, 0.23 for right internal thoracic artery, 0.29 for gastroepiploic artery, and 0.25 for the conventionally harvested saphenous vein). Conclusions Compared with the conventionally harvested saphenous vein, only the RA and no‐touch saphenous vein grafts are associated with significantly lower graft occlusion rates. The RA ranks as the best conduit. Registration URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42020164492.

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