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Published on: March 27, 2018
A Comparative Analysis of Short-Term Outcomes of Off Pump Coronary Artery Bypass Grafting Alone or Simultaneous
Bo Li1, Qing-Rui Fang2, Bo-Chen Yao2
1ICU Department of Cardiovascular Surgery, Tianjin University Chest Hospital, Tianjin, China.
Insights
Simultaneous coronary artery bypass grafting (CABG) with cerebral revascularization showed similar short-term outcomes and mortality compared to isolated CABG. This combined approach may offer benefits in managing systemic vasculopathy, including reduced hospitalization duration.
Area of Science:
- Cardiovascular Surgery
- Neurosurgery
- Vascular Surgery
Background:
- Patients with coronary and cerebrovascular disease often require surgical intervention.
- The optimal surgical strategy, whether combined or staged procedures, remains debated.
- Severe carotid stenosis poses a significant risk during cardiac surgery.
Purpose of the Study:
- To evaluate the impact of simultaneous coronary artery bypass grafting (CABG) with cerebral revascularization versus isolated CABG on perioperative complications and short-term outcomes.
- To compare outcomes in patients with severe carotid stenosis undergoing combined cardio-cerebrovascular revascularization versus isolated off-pump CABG (OPCABG).
Main Methods:
- Retrospective analysis of patients undergoing OPCABG between May 2023 and May 2025.
- Two groups: combined cardio-cerebrovascular revascularization (n=57) and isolated OPCABG (n=60).
- Primary endpoints: 30-day mortality and all-cause mortality. Monitored cardiac, hepatic, and renal function biomarkers; Kaplan-Meier survival analysis.
Main Results:
- Median follow-up of 11.5 months.
- No significant differences in 30-day or all-cause mortality between groups.
- Comparable cardiac, hepatic, and renal function postoperatively.
- Combined approach resulted in shorter hospitalization duration.
Conclusions:
- Simultaneous cardio-cerebrovascular revascularization and isolated CABG demonstrate comparable short-term outcomes.
- The combined approach is a clinically significant advancement for managing systemic vasculopathy.
- This strategy offers a viable option for patients with concomitant coronary and carotid artery disease.
Objectives:
The impact of simultaneous coronary artery bypass grafting (CABG) with cerebral revascularization versus CABG alone on perioperative complications and short-term outcomes remains controversial in patients with simultaneous coronary and cerebrovascular disease. Our study was specifically designed to evaluate the effects of simultaneous cardio-cerebrovascular revascularization versus isolated off-pump CABG (OPCABG) in patients with severe carotid stenosis.
Methods:
This retrospective analysis included patients undergoing OPCABG between May 2023 and May 2025. Participants were divided into two groups based on simultaneous carotid revascularization status, including the combined cardio-cerebrovascular revascularization group (n = 57) and the isolated OPCABG control group (n = 60). The primary endpoints comprised 30-day mortality and all-cause mortality during follow-up. Cardiac, hepatic, and renal function biomarkers were monitored daily for three consecutive postoperative days. Kaplan-Meier analysis demonstrated the survival probability of patients undergoing different surgical procedures throughout the follow-up period.
Results:
Our study with a median follow-up of 11.5 months (IQR: 6.8-20.0 months) observed a lower short-term mortality rate of 5.3% (3/57) in the combined cardio-cerebrovascular revascularization group. Our results demonstrated no significant differences in 30-day mortality and all-cause mortality during follow-up between the combined cardio-cerebrovascular intervention and isolated OPCABG. No intergroup differences were observed in cardiac, hepatic, or renal function within the first three postoperative days. The combined surgical approach reduced hospitalization duration.
Conclusion:
Our findings demonstrated comparable short-term outcomes between patients receiving simultaneous cardio-cerebrovascular revascularization and those undergoing isolated CABG. This simultaneous intervention represents a clinically meaningful advancement in managing systemic vasculopathy.
