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Published on: October 11, 2024
Single- Versus Multi-Vessel Coronary Artery Bypass Grafting During Lung Transplantation
Connor Moynihan1, Neusha Hollingsworth1, Sean Kelleher1
1Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Insights
Multivessel coronary artery bypass grafting (CABG) during lung transplantation is safe and does not impact short- or long-term survival compared to single-vessel CABG. This supports extensive revascularization in select lung transplant recipients.
Area of Science:
- Cardiology
- Thoracic Surgery
- Transplantation Medicine
Background:
- Concomitant coronary artery bypass grafting (CABG) during lung transplantation is feasible but the impact of graft number on outcomes is unknown.
- This study investigates the association between multivessel CABG and survival in lung transplant patients.
Purpose of the Study:
- To compare short- and long-term survival in lung transplant recipients undergoing single-vessel versus multivessel CABG.
- To assess the safety and feasibility of extensive revascularization during lung transplantation.
Main Methods:
- Retrospective cohort study of 78 lung transplant patients with concomitant CABG (2012-2025).
- Patients were grouped into single-vessel (n=43) and multivessel (n=35) CABG cohorts.
- Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models were used for survival analysis.
Main Results:
- Baseline characteristics were similar between groups.
- Early mortality (30- and 90-day) and five-year survival rates showed no significant differences between single-vessel and multivessel CABG.
- Multivessel CABG was not associated with increased mortality (HR 0.77, P=0.415).
Conclusions:
- Multivessel CABG can be safely performed during lung transplantation.
- Extensive revascularization via multivessel CABG does not compromise survival in appropriately selected lung transplant patients.
Introduction:
Concomitant coronary artery bypass grafting (CABG) during lung transplantation is feasible for select patients, yet the effect of the number of bypass grafts and extent of revascularization on outcomes has yet to be investigated. This study evaluates whether multivessel CABG is associated with differences in short- and long-term survival compared to single-vessel CABG.
Methods:
We conducted a retrospective cohort study of 78 patients who underwent concomitant CABG with lung transplantation at a single center from 2012 to 2025. Patients were grouped by number of CABGs: single (n = 43) versus multiple (n = 35). Kaplan-Meier curves and log-rank tests were used to compare survival between groups. A Cox proportional hazards model assessed five-y mortality.
Results:
Baseline characteristics, such as age, body mass index, and lung allocation score, were similar between multivessel and single-vessel CABG cohorts. Median sternotomy was more common in multivessel CABG (71.4% versus 30.2%, P < 0.001). Early mortality was similar in both groups: 30 d (2.9% versus 0%, P = 0.268) and 90 d (8.6% versus 2.3%, P = 0.208). Five-year survival was 52.4% for multivessel versus 39.3% for single-vessel CABG (P = 0.220). Cox modeling demonstrated that multivessel CABG was not associated with increased mortality (hazard ratio 0.77, 95% confidence interval 0.42-1.43, P = 0.415).
Conclusions:
Multivessel CABG during lung transplantation can be performed safely without compromising short- or long-term survival compared to single-vessel CABG, supporting the feasibility of extensive revascularization in appropriately selected patients.
