Conduit selection and early graft failure in coronary artery bypass surgery: A post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) coronary artery bypass grafting study.

Autor:	Alboom M; Department of Surgery, McMaster University, Hamilton, Ontario, Canada., Browne A; Department of Research, Hamilton Health Sciences, Hamilton, Ontario, Canada., Sheth T; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Zheng Z; Department of Cardiovascular Surgery, Fuwai Hospital, Beijing, China., Dagenais F; Department of Cardiac Surgery, Quebec Heart and Lung Institute affiliated with Laval University, Quebec City, Quebec, Canada., Noiseux N; Department of Cardiac Surgery, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada., Brtko M; Department of Cardiac Surgery, Fakultní nemocnice Hradec Králové, Hradec Králové, Královéhradecký, Czech Republic., Stevens LM; Department of Cardiac Surgery, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada., Lee SF; Department of Statistics, Population Health Research Institute, Hamilton, Ontario, Canada., Copland I; Department of Perioperative Medicine, Population Health Research Institute, Hamilton, Ontario, Canada., Power P; Department of Research, Hamilton Health Sciences, Hamilton, Ontario, Canada., Eikelboom J; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Lamy A; Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Perioperative Medicine, Population Health Research Institute, Hamilton, Ontario, Canada. Electronic address: lamya@mcmaster.ca.
Jazyk:	angličtina
Zdroj:	The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2023 Mar; Vol. 165 (3), pp. 1080-1089.e1. Date of Electronic Publication: 2022 Jun 02.
DOI:	10.1016/j.jtcvs.2022.05.028
Abstrakt:	Objectives: Relative rates of early graft failure and conduit selection in coronary artery bypass grafting (CABG) surgery remain controversial. Therefore, we sought to determine the incidence and determinants of graft failure of the left internal mammary artery (LIMA), radial artery, saphenous vein, and right internal mammary artery (RIMA) 1 year after CABG surgery. Methods: A post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) CABG study, involving patients from 83 centers in 22 countries. We completed an analysis of 3480 grafts from 1068 patients who underwent CABG surgery with complete computed tomography angiography data. The primary outcome was graft failure as diagnosed by computed tomography angiography 1 year after surgery. Results: Graft failure occurred in 6.4% (68/1068) for LIMA, 9.9% (9/91) for radial artery, 10.4% (232/2239) for saphenous vein, and 26.8% (22/82) for RIMA grafts. The RIMA had a greater rate of graft failure (26.8%) than radial artery (9.9%) and veins (10.4%) (adjusted odds ratio, 2.69; 95% confidence interval, 1.30-5.57; P = .008 and adjusted odds ratio, 2.07; 95% confidence interval, 1.33-3.21; P = .001, respectively). Conclusions: In this international trial dataset, LIMA and radial artery performed as expected, whereas vein grafts performed better. However, high rates of RIMA failure are worrisome and highlight the need for a thorough evaluation of the patency and safety of the RIMA in CABG surgery. (Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu