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Eilon Ram, Ilan Goldenberg, Yigal Kassif, Amit Segev, Jacob Lavee, Michal Einhorn-Cohen, Ehud Raanani
OBJECTIVES: Left main coronary artery involvement in patients with multivessel coronary artery disease provides a poor prognosis. Although the main strategy for revascularization is by coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) is being used with increased frequency. METHODS: This prospective, 3-year follow-up study included 1063 consecutive patients with multivessel coronary artery disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and PCI...
March 15, 2018: European Journal of Cardio-thoracic Surgery
Tim Kinnaird, Richard Anderson, Sean Gallagher, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Samuel Copt, James Nolan, Azfar Zaman, Mamas Mamas
OBJECTIVES: Using the British Cardiovascular Intervention Society percutaneous coronary intervention (PCI) database, access site choice and outcomes of patients undergoing PCI with previous coronary artery bypass grafting (CABG) were studied. BACKGROUND: Given the influence of access site on outcomes, use of radial access in PCI-CABG warrants further investigation. METHODS: Data were analyzed from 58,870 PCI-CABG procedures performed between 2005 and 2014...
March 12, 2018: JACC. Cardiovascular Interventions
Harsh Agrawal, Mohamed Teleb, Saba Lahsaei, Luis Carbajal, Ruben Montanez, Joseph P Carrozza
PURPOSE OF THE REVIEW: Coronary artery disease is a major cause of mortality and morbidity in the world, and PCI and CABG account for over a million procedures performed annually in the USA. The goal of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is to achieve complete revascularization (CR) if at all possible. However, restenosis and stent thrombosis (ST) remain the Achilles heel of contemporary PCI with restenosis rates between 10 and 30% with bare metal stents to 5-15% after drug-eluting stents and ST rates of around 0...
March 6, 2018: Current Cardiology Reports
Jessica G Y Luc, Jae Hwan Choi, Syed-Saif Abbas Rizvi, Kevin Phan, Ester Moncho Escrivà, Sinal Patel, Gordon R Reeves, Andrew J Boyle, John W Entwistle, Rohinton J Morris, H Todd Massey, Vakhtang Tchantchaleishvili
Background: Transplant coronary artery vasculopathy (TCAV) is the major cause of late allograft failure and death in heart transplant recipients. The aim of this systematic review was to examine the outcomes of percutaneous coronary interventions (PCIs) as compared to coronary artery bypass grafting (CABG) surgery in the management of TCAV. Our secondary objective was to compare the use and outcomes of drug eluting stents (DES) as compared to bare metal stents (BMS) in this patient population...
January 2018: Annals of Cardiothoracic Surgery
Fausto Biancari, Vesa Anttila, Angelo M Dell'Aquila, Juhani K E Airaksinen, Debora Brascia
BACKGROUND: Perioperative myocardial ischemia (PMI) in patients undergoing coronary artery bypass grafting (CABG) is associated with poor outcome. The aim of this study was to pool the available data on the outcome after control angiography and repeat revascularization in patients with perioperative myocardial ischemia (PMI) after coronary artery bypass grafting (CABG). METHODS: A literature review was performed through PubMed, Scopus, ScienceDirect and Google Scholar to identify studies published since 1990 evaluating the outcome of PMI after CABG...
February 27, 2018: Journal of Cardiothoracic Surgery
Stuart J Head, Milan Milojevic, Joost Daemen, Jung-Min Ahn, Eric Boersma, Evald H Christiansen, Michael J Domanski, Michael E Farkouh, Marcus Flather, Valentin Fuster, Mark A Hlatky, Niels R Holm, Whady A Hueb, Masoor Kamalesh, Young-Hak Kim, Timo Mäkikallio, Friedrich W Mohr, Grigorios Papageorgiou, Seung-Jung Park, Alfredo E Rodriguez, Joseph F Sabik, Rodney H Stables, Gregg W Stone, Patrick W Serruys, Arie Pieter Kappetein
BACKGROUND: Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS: We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CABG with PCI using stents. Eligible studies included patients with multivessel or left main coronary artery disease who did not present with acute myocardial infarction, did PCI with stents (bare-metal or drug-eluting), and had more than 1 year of follow-up for all-cause mortality...
February 22, 2018: Lancet
Eilon Ram, Ilan Goldenberg, Yigal Kassif, Amit Segev, Jakob Lavee, Nir Shlomo, Ehud Raanani
BACKGROUND: The regional needs and consolidation of cardiac surgery services (CSS) result in an increased number of stand-alone interventional cardiology units. We aimed to explore the impact of a heart team on the decision making and outcomes of patients with multivessel coronary artery disease referred for coronary revascularization in stand-alone interventional cardiology units. METHODS: This prospective study included 1063 consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and percutaneous coronary intervention (PCI), with or without on-site CSS...
March 2018: Journal of Thoracic and Cardiovascular Surgery
Ioanna Kosmidou, Shmuel Chen, A Pieter Kappetein, Patrick W Serruys, Bernard J Gersh, John D Puskas, David E Kandzari, David P Taggart, Marie-Claude Morice, Paweł E Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Joseph F Sabik, Thomas McAndrew, Björn Redfors, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). OBJECTIVES: This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes. METHODS: In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG...
February 20, 2018: Journal of the American College of Cardiology
Waleed E Ali, Satyanarayana R Vaidya, Sylvester U Ejeh, Kingsley U Okoroafor
BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies...
February 2018: Medicine (Baltimore)
Chieh-Shou Su, Yu-Wei Chen, Ching-Hui Shen, Tsun-Jui Liu, Yen Chang, Wen-Lieng Lee
Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013...
February 2018: Medicine (Baltimore)
Sung-Jin Hong, Byeong-Keuk Kim, Sanghoon Shin, Yongsung Suh, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
BACKGROUND: The long-term outcome of percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG), particularly for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), remains controversial.Methods and Results:We retrospectively analyzed 2,827 patients (stable coronary artery disease [SCAD], n=1,601; NSTE-ACS, n=1,226) who underwent either PCI (n=1,732) or CABG (n=1,095). The 8-year composite of cardiac death and myocardial infarction (MI) was compared between PCI and CABG before and after propensity matching...
February 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Lorenzo Azzalini, Soledad Ojeda, Aris Karatasakis, Joren Maeremans, Masaki Tanabe, Alessio La Manna, Rustem Dautov, Luiz F Ybarra, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Ozan M Demir, Francisco Hidalgo, Judit Karacsonyi, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel Pan, Mauro Carlino, Joseph Dens, Emmanouil S Brilakis, Antonio Colombo, Stéphane Rinfret
BACKGROUND: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in France, the Netherlands, Belgium, and United Kingdom (RECHARGE) score in predicting acute and long-term outcomes. METHODS: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017...
December 26, 2017: Canadian Journal of Cardiology
Marc-Alexander Ohlow, Ahmed Farah, Thomas Kuntze, Bernward Lauer
BACKGROUND: The decision for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in patients with multi-vessel coronary artery disease (mCAD) is currently made by a heart-team approach. Patients' preference is less well investigated. METHODS: All consecutive patients with prior CABG and at least 2 PCI procedures were interviewed whether they would elect bypass surgery or staged PCI in case of a hypothetical scenario in which they had mCAD and CABG or PCI will equally improve symptoms and survival...
January 9, 2018: International Journal of Clinical Practice
Alexis L Beatty, Michael Truong, David W Schopfer, Hui Shen, Justin M Bachmann, Mary A Whooley
Background -Cardiac rehabilitation is strongly recommended after myocardial infarction (MI), percutaneous coronary intervention (PCI), or coronary artery bypass surgery (CABG), but is historically underused. We sought to evaluate variation in cardiac rehabilitation participation across the United States. Methods -From administrative data from the Veterans Affairs (VA) healthcare system and a 5% Medicare sample, we used ICD-9 codes to identify patients hospitalized for MI, PCI, or CABG from 2007-2011. After excluding patients who died within 30 days of hospitalization, we calculated the percent of patients who participated in one or more outpatient visits for cardiac rehabilitation during the 12 months after hospitalization...
January 5, 2018: Circulation
Paul G Barnett, Juliette S Hong, Evan Carey, Gary K Grunwald, Karen Joynt Maddox, Thomas M Maddox
Importance: The Veterans Affairs (VA) Community Care (CC) Program supplements VA care with community-based medical services. However, access gains and value provided by CC have not been well described. Objectives: To compare the access, cost, and quality of elective coronary revascularization procedures between VA and CC hospitals and to evaluate if procedural volume or publicly reported quality data can be used to identify high-value care. Design, Setting, and Participants: Observational cohort study of veterans younger than 65 years undergoing an elective coronary revascularization, controlling for differences in risk factors using propensity adjustment...
January 3, 2018: JAMA Cardiology
Joanna Foik, Anna Brzęk, Marek J Gierlotka, Michał O Zembala, Mariusz Gąsior, Marian Zembala
INTRODUCTION    Rehabilitation after coronary revascularization procedures is an intrinsic element of treatment during the in-hospital period. OBJECTIVES    The aim of this study was to compare the course and effects of rehabilitation in patients receiving hybrid or classical treatment during the in-hospital period. PATIENTS AND METHODS    Two hundred patients participating in a prospective, random-ized clinical trial (POLMIDES), that assessed the effect of hybrid treatment on in-hospital outcomes and remote results in patients with multi-vessel coronary artery disease were ana-lysed...
January 2, 2018: Polish Archives of Internal Medicine
Krishnan Ramanathan, James G Abel, Julie E Park, Anthony Fung, Verghese Mathew, Carolyn M Taylor, G B John Mancini, Min Gao, Lillian Ding, Subodh Verma, Karin H Humphries, Michael E Farkouh
BACKGROUND: Randomized trial data support the superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention (PCI) in diabetic patients with multivessel coronary artery disease (MV-CAD). However, whether this benefit is seen in a real-world population among subjects with stable ischemic heart disease (SIHD) and acute coronary syndromes (ACS) is unknown. OBJECTIVES: The main objective of this study was to assess the generalizability of the FREEDOM (Future REvascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial in real-world practice among patients with diabetes mellitus and MV-CAD in residents of British Columbia, Canada...
December 19, 2017: Journal of the American College of Cardiology
Yang Li, Ran Dong, Kun Hua, Tao-Shuai Liu, Shao-You Zhou, Ning Zhou, Hong-Jia Zhang
BACKGROUND: Debate on treatment for young patients with coronary artery disease still exists. This study aimed to investigate the intermediate- and long-term outcomes between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients aged 18-45 years with diabetes mellitus (DM). METHODS: Between January 2006 and March 2016, a total of 2018 DM patients aged 18-45 years including 517 cases of CABG and 1501 cases of PCI were enrolled in the study...
December 20, 2017: Chinese Medical Journal
Alaide Chieffo, Akihito Tanaka, Gennaro Giustino, Ieva Briede, Fadi J Sawaya, Joost Daemen, Hiroyoshi Kawamoto, Emanuele Meliga, Fabrizio D'Ascenzo, Enrico Cerrato, Giulio G Stefanini, Davide Capodanno, Andrea Mangiameli, Christian Templin, Andrejs Erglis, Marie Claude Morice, Roxana Mehran, Nicolas M Van Mieghem, Sunao Nakamura, Mauro De Benedictis, Marco Pavani, Ferdinando Varbella, Marco Pisaniello, Samin K Sharma, Corrado Tamburino, Didier Tchetche, Antonio Colombo
OBJECTIVES: The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a "real world" population. BACKGROUND: PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. METHODS: All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry...
December 11, 2017: JACC. Cardiovascular Interventions
Ricardo das Neves, Greicy Kelly Avila, Fernando de Barros Oliveira, João Augusto Ferraz de Sampaio
INTRODUCTION: Smoking is a serious public health issue, being a precursor of heart disease and a predictor of sudden death due to myocardial ischemia. Major events in the patient's health can lead to radical changes in habits and the choice for different myocardial revascularization methods might differently impact smoking cessation and relapse. OBJECTIVE: To study the rate and perpetuation of smoking cessation after myocardial revascularization comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)...
September 2017: Brazilian Journal of Cardiovascular Surgery
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