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Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives
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Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 4628

Special Issue Editors

Prof. Dr. Omer Dzemali

E-Mail Website
Guest Editor
1. Department of Cardiac Surgery, University Hospital of Zurich, 8091 Zurich, Switzerland
2. Department of Cardiac Surgery, City Hospital of Zurich—Triemli, 8063 Zurich, Switzerland
3. Cardiosurgery Allianz Zurich, Zurich, Switzerland
Interests: heart failure; cardiac surgery; cardiopulmonary bypass; aortic diseases; heart valve diseases; mitral valve surgery; coronary artery bypass surgery; off-pump coronary artery bypass; minimally invasive cardiac surgery; TAVI; thoracic aortic aneurysm; thoracic aorta; hemodynamics perfusion; aortic valve; coronary artery bypass
Special Issues, Collections and Topics in MDPI journals
Dr. Hector Rodriguez

E-Mail Website
Guest Editor
Department of Cardiac Surgery, City Hospital of Zurich—Triemli, 8063 Zurich, Switzerland
Interests: cardiovascular system; cardiac surgery; coronary artery bypass; transplants; immune response; inflammation mediators; heart transplantation; cardiomyopathies; coronary artery bypass surgery; aortic valve; immune system; immunity; inflammation; transcatheter aortic valve implantation; autophagy; molecular biology; apoptosis

Special Issue Information

Dear Colleagues,

Coronary artery bypass grafting (CABG) remains the "gold standard" treatment for advanced coronary artery disease. The advantages of coronary artery bypass excel in multivessel conditions and complex disease anatomy; however, controversies remain despite CABG's proven success compared to coronary stent implantation.

Most of the data supporting CABG as a superior alternative for long-term outcomes and complex multivessel diseases are somehow outdated and obscured by the newest data from recent stent studies.

Indeed, technological advances are more pronounced in stents; nevertheless, improvements in CABG are on par with those presented in the newest clinical stent trials.

In this special issue — Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives — we aim to collect and showcase high-quality reviews, original papers, and clinical trials presenting novel clinical and technological advances in CABG surgery.  

The papers in this special issue should highlight improved long-term outcomes, novel devices, and novel surgical techniques in CABG surgery, including off-pump and on-pump, minimally invasive direct coronary artery bypass and robotic coronary artery bypass surgery.

Prof. Dr. Omer Dzemali
Dr. Hector Rodriguez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary artery bypass graft
  • hybrid cardiac surgery
  • robotics
  • video-assisted
  • minimaly invasive CABG
  • endoscopic graft harvesting
  • off pump CABG
  • MIDCAB
  • MixCAB
  • graft patency

Published Papers (3 papers)

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Research

16 pages, 1318 KiB  
Article
Thirteen Years of Impactful, Minimally Invasive Coronary Surgery: Short- and Long-Term Results for Single and Multi-Vessel Disease
by Lilly Ilcheva, Achim Häussler, Magdalena Cholubek, Vasileios Ntinopoulos, Dragan Odavic, Stak Dushaj, Hector Rodriguez Cetina Biefer and Omer Dzemali
J. Clin. Med. 2024, 13(3), 761; https://doi.org/10.3390/jcm13030761 - 28 Jan 2024
Cited by 1 | Viewed by 928
Abstract
Objectives: Minimally invasive coronary surgery (MICS) via lateral thoracotomy is a less invasive alternative to the traditional median full sternotomy approach for coronary surgery. This study investigates its effectiveness for short- and long-term revascularization in cases of single and multi-vessel diseases. Methods: A [...] Read more.
Objectives: Minimally invasive coronary surgery (MICS) via lateral thoracotomy is a less invasive alternative to the traditional median full sternotomy approach for coronary surgery. This study investigates its effectiveness for short- and long-term revascularization in cases of single and multi-vessel diseases. Methods: A thorough examination was performed on the databases of two cardiac surgery programs, focusing on patients who underwent minimally invasive coronary bypass grafting procedures between 2010 and 2023. The study involved patients who underwent either minimally invasive direct coronary artery bypass grafting (MIDCAB) for the revascularization of left anterior descending (LAD) artery stenosis or minimally invasive multi-vessel coronary artery bypass grafting (MICSCABG). Our assessment criteria included in-hospital mortality, long-term mortality, and freedom from reoperations due to failed aortocoronary bypass grafts post-surgery. Additionally, we evaluated significant in-hospital complications as secondary endpoints. Results: A total of 315 consecutive patients were identified between 2010 and 2023 (MIDCAB 271 vs. MICSCABG 44). Conversion to median sternotomy (MS) occurred in eight patients (2.5%). The 30-day all-cause mortality was 1.3% (n = 4). Postoperative AF was the most common complication postoperatively (n = 26, 8.5%). Five patients were reoperated for bleeding (1.6%), and myocardial infarction (MI) happened in four patients (1.3%). The mean follow-up time was six years (±4 years). All-cause mortality was 10.3% (n = 30), with only five (1.7%) patients having a confirmed cardiac cause. The reoperation rate due to graft failure or the progression of aortocoronary disease was 1.4% (n = 4). Conclusions: Despite the complexity of the MICS approach, the results of our study support the safety and effectiveness of this procedure with low rates of mortality, morbidity, and conversion for both single and multi-vessel bypass surgeries. These results underscore further the necessity to implement such programs to benefit patients. Full article
(This article belongs to the Special Issue Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives)
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10 pages, 820 KiB  
Article
Minimal Extracorporeal Circulation and Microplegia in the Setting of Urgent Coronary Artery Bypass Grafting
by Luca Koechlin, Brigitta Gahl, Jules Miazza, Urs Zenklusen, Bejtush Rrahmani, Ion Vasiloi, David Santer, Denis Berdajs, Friedrich S. Eckstein and Oliver Reuthebuch
J. Clin. Med. 2022, 11(24), 7488; https://doi.org/10.3390/jcm11247488 - 17 Dec 2022
Viewed by 1294
Abstract
Background: We aimed to analyse the performance of minimal invasive extracorporeal circulation (MiECC) concomitantly with Microplegia, in patients with recent myocardial infarction (MI) undergoing urgent coronary artery bypass grafting (CABG) surgery. Methods: We included patients with a recent MI (≤7 days) undergoing isolated [...] Read more.
Background: We aimed to analyse the performance of minimal invasive extracorporeal circulation (MiECC) concomitantly with Microplegia, in patients with recent myocardial infarction (MI) undergoing urgent coronary artery bypass grafting (CABG) surgery. Methods: We included patients with a recent MI (≤7 days) undergoing isolated CABG surgery using MiECC. The primary endpoint was a major cardiovascular or cerebrovascular event (MACCE). In a secondary analysis, we compared our institutional Microplegia concept with the use of a crystalloid single-shot cardioplegic solution. Results: In total, 139 patients (mean ± standard deviation (SD) age 66 ± 10 years) underwent urgent CABG surgery using Microplegia; 55% (n = 77) of the patients had an acute MI within 1–7 days preoperatively; 20% (n = 28) had an acute MI within 6–24 h; and 24% (n = 34) had an acute MI within <6 h preoperatively. The number of distal anastomoses was a geometric mean of 4 (95% confidence interval 3–4). The MACCE and in-hospital mortality were 7% (n = 10) and 1% (n = 2), respectively. The results were confirmed in a secondary analysis comparing Microplegia with crystalloid cardioplegic solution (n = 271). Conclusion: The use of MiECC with Microplegia in urgent CABG surgery is feasible and safe and provides a straight-forward intraoperative setting. Therefore, it can also be considered to retain the benefits of MiECC in urgent CABG surgery. Full article
(This article belongs to the Special Issue Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives)
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12 pages, 1650 KiB  
Article
Outcomes of Patients Undergoing Closed Traction Coronary Endarterectomy: A Long-Term Single Center Study
by Sharaf-Eldin Shehada, Fanar Mourad, Ali Haddad, Belal Darwish, Noura Ryadi, Ilir Balaj, Heinz Jakob and Arjang Ruhparwar
J. Clin. Med. 2022, 11(23), 7026; https://doi.org/10.3390/jcm11237026 - 28 Nov 2022
Cited by 1 | Viewed by 1495
Abstract
Background—Coronary endarterectomy (CEA) is an option for treating severely diffused coronary artery diseases; however, many surgeons avoid performing it due to its complexity and reported controversial results. Therefore, we aimed to review the results of patients undergoing CEA within coronary artery bypass grafting [...] Read more.
Background—Coronary endarterectomy (CEA) is an option for treating severely diffused coronary artery diseases; however, many surgeons avoid performing it due to its complexity and reported controversial results. Therefore, we aimed to review the results of patients undergoing CEA within coronary artery bypass grafting (CABG). Methods—This is a retrospective observational study evaluating the results of patients undergoing CEA within CABG surgery between March 2003 and February 2018. Follow-up via active personal and/or telephone interviews was performed to evaluate long-term clinical outcomes. The study endpoints included early postoperative incidence of myocardial infarction or cardiac mortality, long-term survival, and freedom from major adverse cardiac and cerebrovascular events (MACCE). Results—A total of 326 patients were included in this study for evaluation. The patients’ mean age was 67 years; 88% were male, and most presented with three-vessel disease, reporting a mean SYNTAX score of 33.1 ± 12. Approximately 5.5% (n = 18) of the patients had undergone previous CABG surgery. A total of 394 CEAs within a mean of 4.3 ± 1.1 grafts per patient were performed. The indication for CEA was either totally (n = 111, 28.2%) or sub-totally (n = 283, 71.8%) occluded coronary arteries. Early results included perioperative myocardial infarction in eight (2.4%), stroke in eight (2.4%), and in-hospital mortality in thirteen (4.0%) patients. Long-term clinical follow-up reported mortality in 27.6% and overall incidence of MACCE in 41.4% of the patients at the ten-year follow-up. Conclusions—Patients with severe and diffuse CAD are difficult candidates for surgical revascularization. CEA offers an option to allow complete revascularization, even in the case of chronic occlusion, when the myocardium is still viable. The closed traction CEA technique presented here is our preferred method; it achieves satisfactory short- and long-term results. Full article
(This article belongs to the Special Issue Coronary Artery Bypass Grafting: Current Knowledge and Future Perspectives)
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