Background: It is current practice to perform concomitant coronary artery bypass grafting (CABG) in patients with infective endocarditis (IE) who have relevant coronary artery disease (CAD). However, CABG may add complexity to the operation. We aimed to investigate the impact of concomitant CABG on perioperative outcomes in patients undergoing surgery for IE.
Methods: We retrospectively used data of surgically treated IE patients between 1994 and 2018 in six German cardiac surgery centers. We performed inverse probability weighting (IPW), multivariable adjustment, chi-square analysis, and Kaplan-Meier survival estimates.
Results: CAD was reported in 1242/4917 (25%) patients. Among them, 527 received concomitant CABG. After adjustment for basal characteristics between CABG and no-CABG patients using IPW, concomitant CABG was associated with higher postoperative stroke (26% vs. 21%, = 0.003) and a trend towards higher postoperative hemodialysis (29% vs. 25%, = 0.052). Thirty-day mortality was similar in both groups (24% vs. 23%, = 0.370). Multivariate Cox regression analysis after IPW showed that CABG was not associated with better long-term survival (HR: 1.00, 95% CI: 0.82-1.23, = 0.998).
Conclusion: In endocarditis patients with CAD, adding CABG to valve surgery may be associated with a higher likelihood of postoperative stroke without adding long-term survival benefits. Therefore, in the absence of critical CAD, concomitant CABG may be omitted without impacting outcome. The results are limited due to a lack of data on the severity of CAD, and therefore there is a need for a randomized trial.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267636 | PMC |
| http://dx.doi.org/10.3390/jcm10132867 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Machine learning-derived multivariable predictors of postcardiotomy cardiogenic shock in high-risk cardiac surgery patients.
JTCVS Open
December 2024
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Objective: To develop a model for preoperatively predicting postcardiotomy cardiogenic shock (PCCS) in patients with poor left ventricular (LV) function undergoing cardiac surgery.
Methods: From the Society of Thoracic Surgeons Adult Cardiac Database, 11,493 patients with LV ejection fraction ≤35% underwent isolated on-pump surgery from 2018 through 2019, of whom 3428 experienced PCCS. In total, 68 preoperative clinical variables were considered in machine-learning algorithms trained and optimized using scikit-learn software.
Simultaneous gastroepiploic artery to right coronary artery bypass and trans-catheter aortic valve implantation: case series.
Gen Thorac Cardiovasc Surg Cases
January 2025
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
Patients with coronary artery disease undergoing trans-catheter aortic valve implantation (TAVI) often receive TAVI alone. However, in cases of severe coronary lesions or anticipated difficulty in coronary access post-TAVI, percutaneous coronary intervention or coronary artery bypass grafting may be necessary. We performed simultaneous gastroepiploic artery to posterior descending artery bypass and TAVI in two patients with severe calcification of the right coronary artery ostium which is unsuitable for percutaneous intervention.
View Article and Find Full Text PDFOutcomes of acute type A aortic dissection repair in patients under the age of 75 versus 75 and older.
Perfusion
January 2025
Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Objective: Elderly patients are less likely to undergo surgery for an acute type A aortic dissection (ATAAD). This study aims to understand the risks of surgical treatment in patients 75 and older.
Methods: This was a retrospective study using an institutional database of patients who underwent ATAAD repair from 2007 to 2021.
Predictors of the Need for Permanent Pacemaker Implantation After Surgical Aortic Valve Replacement with a Biological Prosthesis and the Effect on Long-Term Survival.
J Cardiovasc Dev Dis
December 2024
Faculty of Medicine & Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
The need for a permanent pacemaker (PPM) implantation after surgical aortic valve implantation (SAVR) is a recognized postoperative complication, with potentially long-term reduced survival. From 1987 to 2017, 2500 consecutive patients underwent SAVR with a biological valve with or without concomitant procedures such as CABG or mitral valve repair. Mechanical valves or valves in another position were excluded.
View Article and Find Full Text PDFThe Impact of the Coexistence of Frailty Syndrome and Cognitive Impairment on Early and Midterm Complications in Older Patients with Acute Coronary Syndromes.
J Clin Med
December 2024
Department of Cardiology, Marciniak Lower Silesian Specialist Hospital-Emergency Medicine Center, 54-049 Wroclaw, Poland.
The ageing population has heightened interest in the prognostic role of geriatric conditions, notably frailty syndrome (FS) and cognitive impairment (CI). Evidence indicates a significant link between cardiovascular disease, FS, and CI. However, limited research has explored the impact of impaired functional and cognitive performance on outcomes in acute coronary syndrome (ACS) patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!