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Updated: May 5, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Published on: April 24, 2017

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The Clinical Significance of Unplanned Coronary Artery Bypass Grafting in Aortic Root Replacement

Takuya Ogami1, Derek Serna-Gallegos2, Sarah Yousef1

  • 1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA.

Journal of Cardiothoracic and Vascular Anesthesia
|February 2, 2024
PubMed

Insights

Unplanned coronary artery bypass grafting (CABG) during aortic root replacement (ARR) occurred in 4.3% of patients and did not increase mortality risk. Smaller body surface area was linked to a higher chance of needing unplanned CABG.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Aortic root replacement (ARR) sometimes necessitates unplanned coronary artery bypass grafting (CABG).
  • The implications of unplanned CABG during ARR are not well-established.

Purpose of the Study:

  • To evaluate the impact of unplanned CABG on mortality in patients undergoing ARR.
  • To identify risk factors associated with unplanned CABG during ARR.

Main Methods:

  • Retrospective observational study at a single tertiary care center.
  • Analysis of 795 patients who underwent ARR between 2011 and 2022.
  • Comparison of outcomes between patients with and without unplanned CABG.

Main Results:

  • Unplanned CABG was required in 4.3% of ARR patients.
  • Indications for unplanned CABG included ventricular dysfunction, disease pathology, anatomy, and surgical complications.
  • Unplanned CABG was not associated with increased operative or long-term mortality.
  • A body surface area < 1.7 m² was independently associated with a higher risk of unplanned CABG.

Conclusions:

  • Unplanned CABG during ARR is infrequent and does not appear to elevate mortality risks.
  • Patient body surface area is a significant factor predicting the need for unplanned CABG during ARR.
Abstract

Keywords:
aortic root replacementbody surface areacoronary artery bypass graftingcoronary artery disease

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