Related Experiment Video
Updated: Jul 16, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Postoperative outcome after coronary artery bypass grafting in chronic obstructive pulmonary disease
Hélène Manganas1, Yves Lacasse, Stéphanie Bourgeois
1Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Université Laval, Sainte-Foy, Québec.
Insights
The severity of airflow obstruction in chronic obstructive pulmonary disease (COPD) does not impact mortality after coronary artery bypass grafting (CABG). However, severe COPD patients experienced increased pulmonary infections and longer hospital stays.
Area of Science:
- Cardiology
- Pulmonology
- Thoracic Surgery
Background:
- The impact of chronic obstructive pulmonary disease (COPD) severity on outcomes following coronary artery bypass grafting (CABG) remains unclear.
- Assessing preoperative airflow obstruction is crucial for risk stratification in cardiac surgery patients.
Purpose of the Study:
- To determine if the presence and severity of airflow obstruction in COPD patients predict morbidity and mortality after CABG.
- To evaluate the association between COPD severity and postoperative complications such as pulmonary infections and length of hospital stay.
Main Methods:
- A retrospective analysis of 322 patients who underwent CABG between 1998 and 2003 with available preoperative spirometry.
- Patients were categorized into control, mild-to-moderate COPD, and severe COPD groups based on forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) ratios.
- COPD diagnosis criteria included irreversible airflow obstruction in smokers or ex-smokers aged 50 years or older.
Main Results:
- Mortality rates were comparable across all groups (3.0% in controls, 2.6% in mild-to-moderate COPD, 0% in severe COPD).
- Patients with severe COPD had a significantly higher incidence of pulmonary infections (26.5%) compared to other groups (12.4%-12.9%).
- Severe COPD was associated with a slightly longer hospital stay (mean difference 0.7 days) and a trend towards increased atrial fibrillation.
Conclusions:
- The presence and severity of airflow obstruction in COPD do not significantly influence mortality rates after CABG.
- Severe COPD is linked to an increased risk of postoperative pulmonary infections and prolonged hospital stays following CABG.
- Preoperative spirometry can help identify COPD patients at higher risk for specific complications after CABG, guiding perioperative management.
Background:
It is uncertain if the presence and severity of airflow obstruction in chronic obstructive pulmonary disease (COPD) is predictive of surgical morbidity and mortality after coronary artery bypass grafting (CABG).
Methods:
Retrospective study of patients who underwent CABG between 1998 and 2003 in a university-affiliated hospital for whom a preoperative spirometry was available. COPD was diagnosed in smokers or ex-smokers 50 years of age or older in the presence of irreversible airflow obstruction. Patients were divided into three groups depending on the spirometry: controls (forced expiratory volume in 1 s [FEV1] 80% or more, FEV1/forced vital capacity [FVC] greater than 0.7), mild to moderate COPD (FEV1 50% or more and FEV1/FVC 0.7 or less) and severe COPD (FEV1 less than 50% and FEV1/FVC 0.7 or less).
Results:
Among the 411 files studied, 322 (249 men, 68+/-8 years of age) were retained (controls, n=101; mild to moderate COPD, n=153; severe COPD, n=68). The mortality rate (3.0%, 2.6% and 0%, respectively) was comparable among the three groups. Patients with severe COPD had a slightly longer hospital stay than controls (mean difference 0.7+/-1.4 days, P<0.05). Pulmonary infections were more frequent in severe COPD (26.5%) compared with mild to moderate COPD (12.4%) and controls (12.9%), P<0.05. Atrial fibrillation tended to be more frequent in severe COPD than in the other two groups.
Conclusion:
Mortality rate associated with CABG surgery is not influenced by the presence and severity of airflow obstruction in patients with COPD. The incidence of pulmonary infections and length of hospital stay were increased in patients with severe COPD.
More Related Videos
07:28Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
05:25Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation