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October 27, 2021Transplantation and artificial organsOpen Access

Minimally invasive multivessel CABG yields ~3% mortality in high-risk patients, not exceeding predicted rates.

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Why the study?

The study aimed to compare perioperative outcomes of minimally invasive multivessel CABG across patients with existent risk factors and identify possible contraindications to this technique.

Do risk factors such as obesity, old age, diabetes, or EuroSCORE II > 2.0 worsen perioperative outcomes in patients undergoing multivessel CABG through left anterior minitoracotomy?

Population

349 consecutive patients with isolated multivessel coronary artery disease undergoing minimally invasive CABG

Comparison

Presence vs absence of risk factors such as obesity, old age, diabetes, and EuroSCORE II > 2.0

Design

Observational cohort study

Key result

Minimally invasive multivessel coronary artery bypass grafting via left anterior minithoracotomy was safely performed in patients with risk factors, with a 3.27% mortality in the EuroSCORE II > 2.0 group that did not exceed predicted rates.

Authors

OBOleksandr BabliakVDVolodymyr DemianenkoDBD E Babliak

Discussion

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Member takes

Overview

TCRAT appears feasible for multivessel CABG in consecutive patients; hypothesis-generating and requires randomized trials before practice change.

Study Design

Type

Observational (n=349)

Multicenter

No

Structured PICO

Do risk factors such as obesity, old age, diabetes, or EuroSCORE II > 2.0 worsen perioperative outcomes in patients undergoing multivessel CABG through left anterior minitoracotomy?

P
Population
349 patients with isolated multivessel coronary artery disease undergoing minimally invasive CABG via left anterior minithoracotomy, analyzed for perioperative outcomes based on surgical risk factors.
E
Exposure
Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using the technique of total coronary revascularization via left anterior thoracotomy (TCRAT) with peripheral cannulation for cardiopulmonary bypass and cold blood cardioplegia
C
Comparator
Internal comparison between patients with and without specific risk factors (obesity, old age, diabetes, EuroSCORE II > 2.0)
O
Outcome
Intraoperative and postoperative parameters (total operation time, cardiopulmonary bypass time, intensive care unit stay, ventilation time, hospital stay, acute kidney damage, mortality)

Main Result

Absolute Event Rate: 3.27% vs 0%

p-value: p=0.0021

Minimally invasive multivessel CABG through a left anterior thoracotomy is feasible and safe across various patient risk profiles, including obesity, diabetes, and older age, without exceeding predicted mortality rates.

Limitations

  • Single-center study
  • Observational design without randomization
  • Lack of long-term follow-up data

Cite This Study

Babliak et al. (2021) conducted an observational in Multivessel coronary artery disease (n=349). High surgical risk factors (EuroSCORE II > 2.0, obesity, diabetes, or age > 70) vs. Patients without these risk factors was evaluated on Hospital and 30-day mortality (EuroSCORE II > 2.0 vs < 2.0) (p=0.0021). Minimally invasive multivessel coronary artery bypass grafting via left anterior minithoracotomy was safely performed in patients with risk factors, with a 3.27% mortality in the EuroSCORE II > 2.0 group that did not exceed predicted rates.

synapsesocial.com/papers/6aa502eede97ea77ee811842https://doi.org/10.30702/transpaorg/10_21.2710/0317-36/132.2
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