Comparison on 30-day Clinical Outcome Between Simultaneous Hybrid Coronary Revascularization and Off-pump Coronary Artery Bypass Grafting in Patients With Multivessel Coronary Artery Disease
10.3969/j.issn.1000-3614.2018.05.002
- VernacularTitle:一站式复合再血管化技术治疗冠状动脉多支病变患者的30天预后评估
- Author:
Liu-Zhong SHEN
1
;
Sheng-Shou HU
;
Bo XU
;
Yong-Jian WU
;
Feng LV
;
Hui XIONG
;
Li-Huan LI
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心血管外科
- Keywords:
Hybrid coronary revascularization;
Coronary artery bypass grafting;
Percutaneous coronary intervention
- From:
Chinese Circulation Journal
2018;33(5):419-423
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: The purpose of this study was to compare the 30-day clinical outcome after simultaneous hybrid coronary revascularization (HCR) with off-pump coronary artery bypass grafting (OPCABG) in patients with multivessel coronary artery disease and evaluate the safety and efficiency of simultaneous hybrid coronary revascularization strategy. Methods: Simultaneous HCR was performed in 533 patients with multivessel coronary artery disease at Fuwai hospital from January 2009 to January 2017. These patients were 1:1 matched with patients underwent OPCABG using propensity score matching method. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE) over the 30-day follow-up post-surgery, and the second endpoints were in-hospital outcomes, including chest tube drainage, transfusion rate, mechanical ventilation time and length of stay in intensive care unit. Results: Chest tube drainage post-surgery (ml)(714 [523, 971] vs 965 [716, 1 220], P<0.001),Blood transfusion rate (19.7% vs 34.0%, P=0.024), mechanical ventilation time (hours) (12.6[9.3, 15.7] vs 16.0 [12.8, 18.7], P<0.001), and stay in intensive care unit (hours) (21.7[19.8, 42.4] vs 41.6[23.6, 70.0], P<0.001) were all significantly reduced in the simultaneous HCR group than in OPCABG group. Mortality, myocardial infarction, stroke, repeat revascularization rate and accumulated MACCE rate during the 30-day follow-up were similar between HCR group and OPCABG group .Conclusions: For selected patients with multivessel coronary artery disease, simultaneous HCR provided a safe and effective alternative revascularization strategy. Simultaneous HCR is associated with less blood loss, faster recovery, and fewer perioperative complications and achieved similar and favorable early outcomes as compared with OPCABG strategy.
