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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Risk factors for venous thromboembolism in individuals undergoing coronary artery bypass grafting

Wenting Du1, Xiaojie Zhao2, Andrew Nunno3

  • 1Department of Geriatrics, Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China; Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|October 18, 2019
PubMed

Insights

Venous thromboembolism (VTE) after coronary artery bypass grafting (CABG) is uncommon but linked to severe complications. Key risk factors include bleeding disorders, heart failure, and long operative times, guiding preventative strategies.

Area of Science:

  • Cardiovascular Surgery
  • Thrombotic Disorders
  • Patient Outcomes

Background:

  • Venous thromboembolism (VTE) is a significant concern following major surgical procedures.
  • Coronary artery bypass grafting (CABG) carries a risk of postoperative VTE, necessitating investigation into its incidence and predictors.

Purpose of the Study:

  • To determine the incidence of VTE after CABG.
  • To identify risk factors associated with VTE development post-CABG.
  • To analyze the complications and outcomes in patients experiencing VTE after CABG.

Main Methods:

  • Analysis of the American College of Surgeons National Surgical Quality Improvement Program database (2012-2015).
  • Inclusion of patients who underwent CABG.
  • Statistical analysis including single-factor and binary logistic regression to identify risk factors and complications.

Main Results:

  • The incidence of VTE post-CABG was 1.75%, with pulmonary embolism at 0.61% and deep vein thrombosis at 1.28%.
  • Independent risk factors for VTE included a history of bleeding disorders, congestive heart failure, and operative time ≥310 minutes.
  • VTE was associated with significantly worse outcomes, including increased rates of reoperation, hospitalization, and various severe postoperative complications.

Conclusions:

  • The overall VTE rate after CABG is low but associated with poorer 30-day outcomes and increased complications.
  • History of bleeding disorders, recent congestive heart failure, and prolonged operative time are independent predictors of VTE.
  • Identifying these risk factors can inform clinical decisions regarding VTE prophylaxis and management strategies.
Abstract

Keywords:
Coronary artery bypass graftNational Surgical Quality Improvement ProgramRisk factorVenous thromboembolism

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