کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2981327 1578627 2013 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Evolving trends of reoperative coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Evolving trends of reoperative coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database
چکیده انگلیسی

ObjectiveThe present study evaluated the evolving trends and outcomes of patients undergoing isolated reoperative coronary artery bypass grafting at Society of Thoracic Surgeons Adult Cardiac Surgery Database–participating institutions.MethodsFrom 2000 to 2009, 72,431 patients underwent isolated reoperative coronary artery bypass grafting and 1,497,254 patients underwent isolated primary coronary artery bypass grafting at Society of Thoracic Surgeons–participating institutions. The demographics, operative characteristics, and risk-adjusted postoperative outcomes were assessed and compared during the study period.ResultsAs a percentage of overall coronary artery bypass grafting volume, reoperative coronary artery bypass grafting decreased from 6.0% (8820/137,267) in 2000 to 3.4% (5734/160,997) in 2009. The unadjusted operative mortality declined from 6.1% (542/8820) in 2000 to 4.6% (261/5734) in 2009 (P < .05). Patients now more frequently present with left main disease (35.1% vs 25.7%; P < .05), myocardial infarction (60.9% vs 55.9%; P < .001), and heart failure (18.4% vs 14.2%; P < .001). Patients also now present more frequently for urgent or emergent surgery (51.6% vs 39%; P < .001) and after previous percutaneous coronary intervention (51% vs 35%; P < .001). They also have a greater incidence of other comorbidities such as increased weight (88 vs 84 kg; P < .001), diabetes (42.5% vs 31.7%; P < .001), hypertension (90.9% vs 73.4%; P < .001), hypercholesterolemia (90.9% vs 73.4%; P < .001), renal failure (2.2% vs 0.7%; P < .001), and cerebrovascular disease (12.4% vs 8.5%; P < .001). Risk-adjusted mortality decreased from 6.0% to 4.6%, a relative risk reduction of 23.7% (P < .001). Risk-adjusted postoperative stroke decreased from 1.9% to 1.6% (P < .001).ConclusionsSurgical coronary revascularization has evolved during the past decade, with reoperative coronary artery bypass grafting now uncommonly performed in contemporary practice. Despite treating patients with more complex coronary artery disease and greater medical comorbidities, significant improvements have occurred in operative morbidity and mortality in this challenging population.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 145, Issue 2, February 2013, Pages 364–372
نویسندگان
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