Simultaneous hybrid coronary revascularization versus off-pump coronary artery bypass grafting for diabetic patients with multivessel coronary artery disease
10.7507/1007-4848.201707058
- VernacularTitle:一站式复合技术与非体外循环冠状动脉旁路移植术治疗合并糖尿病的多支冠状动脉病变的病例对照研究
- Author:
SHEN Liuzhong
1
;
SONG Zhizhao
2
;
HU Shengshou
1
;
XU Bo
3
;
WU Yongjian
3
;
LV Feng
1
;
XIONG Hui
1
;
LI Lihuan
4
Author Information
1. Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China
2. Department of Cardiovascular Surgery, Nanjing Drum Tower Hospital, Nanjing, 210008, P.R.China
3. Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China
4. Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Hybrid coronary revascularization;
coronary artery bypass grafting;
diabetes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(12):916-922
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the in-hospital and midterm outcomes after simultaneous hybrid coronary revascularization (HCR) with off-pump coronary artery bypass grafting (OPCAB) in diabetic patients with multivessel coronary artery disease. Methods One hundred thirty-two diabetic patients with multivessel coronary artery disease underwent one-stop HCR at Fuwai Hospital from January 2010 to January 2015. These patients were 1∶2 matched with those who underwent OPCAB using propensity score matching. Results Simultaneous HCR had less chest tube drainage (618 (420, 811) ml vs. 969 (711, 1 213)ml, P<0.001), lower transfusion rate (19.7% vs. 34.1%, P=0.026), shorter mechanical ventilation time (11.6 (8.2, 14.8) h vs. 16.0 (12.1, 18.7) h, P<0.001), and shorter stay in intensive care unit (21.5 (18.8, 42.0) h vs. 44.6 (23.7, 70.1) h, P<0.001) than OPCAB. During over median 40 months follow-up, simultaneous HCR offered similar major adverse cardiac or cerebrovascular events (MACCE) rate (6.8% vs 9.0%, P=0.826), but lower stroke rate (0%vs 3.0%, P=0.029), compared with OPCAB. Conclusion For selected patients with diabetes, simultaneous HCR provides a safe and effective revascularization alternative. It decreases perioperative invasiveness and incurred similar and favorable midterm outcomes with OPCAB.
