Our Summary

This study aimed to evaluate the effect of using arterial grafts in extensive myocardial revascularization (a surgical procedure to improve blood flow to the heart) on hospital mortality and illness rates. The researchers looked at two groups of patients who underwent coronary artery bypass grafting (a type of heart surgery) with the support of a heart-lung machine. Group A consisted of 898 patients who had their surgeries between 2000 and 2003, and Group B consisted of 1249 patients who had their surgeries between 2009 and 2012.

The study found several significant changes over time. Group B had more patients over 80 years old, more patients with diabetes, and more patients with a history of percutaneous coronary intervention (a non-surgical procedure used to treat the stenotic coronary artery). The average risk score for predicting in-hospital mortality following cardiac surgery was also higher in Group B. Moreover, the average number of distal anastomoses (surgical connections between blood vessels) increased over time.

In-hospital death rates were low and did not significantly differ between the two groups. However, the occurrence of new-onset atrial fibrillation (a heart rhythm disorder) and deep sternal infection (an infection in the chest) increased significantly in Group B compared to Group A. The study concluded that despite patients undergoing coronary artery bypass grafting having increasingly risky profiles, extensive myocardial revascularization using arterial grafts is associated with good early results. The extensive use of arterial grafts was not found to be a risk factor for in-hospital death or chest infection.

FAQs

  1. What was the aim of the study on using arterial grafts in extensive myocardial revascularization?
  2. How did the in-hospital death rates and occurrence of new-onset atrial fibrillation and deep sternal infection differ between the two groups in the study?
  3. Was the use of arterial grafts found to be a risk factor for in-hospital death or chest infection in the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about heart bypass surgery is to follow a healthy lifestyle post-surgery. This includes maintaining a balanced diet, exercising regularly, quitting smoking, and managing stress. These lifestyle changes can help improve overall heart health and reduce the risk of complications after surgery. Additionally, it is important to attend follow-up appointments with your healthcare provider to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended heart bypass surgery include those with severe coronary artery disease, multiple blockages in the heart’s blood vessels, angina (chest pain) that cannot be controlled with medications, and those who have had a heart attack. Additionally, patients with diabetes, a history of percutaneous coronary intervention, and older patients may also be recommended for heart bypass surgery.

Timeline

Before heart bypass surgery, a patient typically undergoes a series of tests and evaluations to determine the extent of their coronary artery disease and assess their overall health. These may include blood tests, imaging tests such as a coronary angiogram, and a stress test. The patient may also be advised to make lifestyle changes, such as quitting smoking or improving their diet, to optimize their health before surgery.

During the surgery itself, the patient is placed under general anesthesia, and the surgeon makes an incision in the chest to access the heart. The surgeon then takes a healthy blood vessel from another part of the body, such as the leg or chest, and uses it to create a bypass around the blocked or narrowed coronary artery. The patient is then monitored closely in the intensive care unit (ICU) immediately after surgery to ensure that they are stable and recovering well.

After heart bypass surgery, the patient will typically spend several days in the hospital recovering. They will be closely monitored for any complications, such as infection or bleeding. The patient will also be given instructions on how to care for their incision, manage pain, and gradually increase their activity level. Cardiac rehabilitation may be recommended to help the patient recover and improve their overall heart health.

In the weeks and months following heart bypass surgery, the patient will need to attend follow-up appointments with their healthcare provider to monitor their progress and make any necessary adjustments to their treatment plan. It is important for the patient to follow their healthcare provider’s recommendations for medications, lifestyle changes, and ongoing care to ensure the best possible outcome after surgery.

What to Ask Your Doctor

  1. What is the purpose of using arterial grafts in extensive myocardial revascularization?

  2. How does the use of arterial grafts in bypass surgery affect the risk of in-hospital mortality?

  3. What are the potential complications or risks associated with using arterial grafts in heart bypass surgery?

  4. How does the average number of distal anastomoses impact the success of the surgery?

  5. What factors should be considered when determining whether arterial grafts are appropriate for a patient’s specific case?

  6. How does the patient’s age, medical history, and overall health impact the decision to use arterial grafts in bypass surgery?

  7. What are the differences in outcomes between patients who underwent surgery between 2000-2003 and those who underwent surgery between 2009-2012?

  8. How does the occurrence of new-onset atrial fibrillation and deep sternal infection compare between patients who received arterial grafts and those who did not?

  9. What follow-up care or monitoring is necessary for patients who have undergone extensive myocardial revascularization with arterial grafts?

  10. Are there any long-term implications or considerations for patients who have undergone heart bypass surgery with the use of arterial grafts?

Reference

Authors: Kindo M, Hoang Minh T, Perrier S, Bentz J, Mommerot A, Billaud P, Mazzucotelli JP. Journal: Interact Cardiovasc Thorac Surg. 2017 Jan;24(1):71-76. doi: 10.1093/icvts/ivw319. Epub 2016 Sep 22. PMID: 27659151