Article
Cardiac & Cardiovascular Systems
Mihaly Karolyi, Matthias Eberhard, Tobias Gloor, Malgorzata Polacin, Robert Manka, Vedran Savic, Andre R. Plass, Paul Robert Vogt, Hatem Alkadhi, Martin O. Schmiady
Summary: Early routine postoperative assessment of coronary artery bypass graft surgery (CABG) with computed tomography angiography (CTA) reveals both cardiac and non-cardiac findings with a high frequency, affecting clinical management in a substantial proportion of patients.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Mario Gaudino, Antonino Di Franco, Deepak L. Bhatt, John H. Alexander, Antonio Abbate, Lorenzo Azzalini, Sigrid Sandner, Garima Sharma, Sunil Rao, Filippo Crea, Stephen E. Fremes, Sripal Bangalore
Summary: The association between graft patency and clinical outcomes is more complex and variable than commonly thought, influenced by factors such as graft type, occlusion timing, myocardium at risk, and patient characteristics. Graft occlusion is often linked to non-fatal events, with graft failure from competitive flow being benign while occlusion in graft-dependent circulation causing clinical symptoms.
EUROPEAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Mario Gaudino, Sigrid Sandner, Kevin R. An, Arnaldo Dimagli, Antonino Di Franco, Katia Audisio, Lamia Harik, Roberto Perezgrovas-Olaria, Giovanni Soletti, Stephen E. Fremes, David L. Hare, Alexander Kulik, Andre Lamy, Joyce Peper, Marc Ruel, Jurrien M. ten Berg, Laura M. Willemsen, Qiang Zhao, Daniel M. Wojdyla, Deepak L. Bhatt, John H. Alexander, Bjorn Redfors
Summary: Graft failure after CABG is common and strongly associated with adverse cardiac events. Age, female sex, and smoking are independent risk factors for graft failure, while statins have a protective effect. Graft failure is associated with an increased risk of myocardial infarction, repeat revascularization, and death.
Article
Cardiac & Cardiovascular Systems
Ilkun Park, Kuk Bin Choi, Joong Hyun Ahn, Wook Sung Kim, Young Tak Lee, Dong Seop Jeong
Summary: For patients undergoing CABG, DM may have no impact on cardiac death, MI, or revascularization rates, but can reduce the risk of graft failure for BITA grafts. For DM patients, strict control of preoperative hyperglycemia can reduce the occurrence of postoperative wound infection and facilitate the use of BITA in CABG.
CARDIOVASCULAR DIABETOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Ju Hyeon Kim, Pil Hyung Lee, Ho Jin Kim, Joon Bum Kim, Sojeong Park, Dae-Sung Kyoung, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Cheol Hyun Chung, Jae Won Lee, Seong-Wook Park
Summary: There is a significant incidence of intracranial bleeding after coronary artery bypass graft surgery, particularly in the early postoperative period. Age ≥ 75 years, hypertension, pre-existing dementia, history of ischemic stroke or transient ischemic attack, and end-stage renal disease were identified as predictors of intracranial bleeding after coronary artery bypass graft surgery.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Garry W. Hamilton, Diem Dinh, Julian Yeoh, Angela L. Brennan, Jordan Fulcher, Anoop N. Koshy, Matias B. Yudi, Christopher M. Reid, David L. Hare, Melanie Freeman, Dion Stub, William Chen, Stephen J. Duffy, Andrew Ajani, Jaishankar Raman, Omar Farouque, David J. Clark
Summary: This study reports the characteristics of arterial graft stenoses and evaluates the feasibility of radial artery percutaneous coronary intervention (PCI). The results show that patients undergoing radial artery PCI had earlier presentation, less frequent acute coronary syndrome, and more common intervention at the ostial or distal anastomosis compared with saphenous vein graft PCI. Patients undergoing radial artery PCI were more likely to have diabetes, peripheral vascular disease, and non-ST-segment elevation myocardial infarction compared with those undergoing native PCI.
JACC-CARDIOVASCULAR INTERVENTIONS
(2023)
Review
Cardiac & Cardiovascular Systems
Lamia Harik, Sigrid Sandner, Mario Gaudino
Summary: The purpose of this review is to examine current issues related to coronary artery graft patency and outcomes. Recent studies have challenged the traditional concept that graft patency is associated with clinical outcomes. Limitations of existing evidence include the lack of a universal definition of graft failure, lack of systematic imaging in contemporary trials, reliance on observational data with selection bias, and high attrition rates for follow-up imaging. The relationship between graft failure and clinical events is complex and variable, but data suggests a possible association with nonfatal events.
CURRENT OPINION IN CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Lamia Harik, Roberto Perezgrovas-Olaria, Giovanni Soletti, Arnaldo Dimagli, Talal Alzghari, Kevin R. R. An, Gianmarco Cancelli, Mario Gaudino, Sigrid Sandner
Summary: Coronary artery bypass grafting (CABG) is a common cardiac surgery with a significant incidence of graft failure, mainly caused by thrombosis. Antithrombotic therapy, particularly dual antiplatelet therapy (DAPT), has been proven effective in reducing graft failure but increases bleeding risk. In contrast, anticoagulant therapy has shown limited efficacy. Future concepts for antithrombotic therapy include P2Y(12) inhibitor monotherapy and short-term DAPT.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Medicine, General & Internal
Francesca Toto, Tiziano Torre, Lucia Turchetto, Viviana Lo Cicero, Sabrina Soncin, Catherine Klersy, Stefanos Demertzis, Enrico Ferrari
Summary: This study compared the efficacy of three solutions in preserving the endothelial cell integrity of saphenous vein grafts. The results showed that DuraGraft better protected the grafts against ischemic-induced apoptosis compared to saline solution. Prolonged ischemia was associated with extended endothelium damage, and none of the studied solutions protected the vein grafts.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Thomas Aschacher, Ulrike Baranyi, Olivia Aschacher, Eva Eichmair, Barbara Messner, Daniel Zimpfer, Roxana Moayedifar, Guenther Laufer, Maximilian Y. Emmert, Sigrid E. Sandner
Summary: The study evaluated the protective effect of an endothelial damage inhibitor on radial artery grafts, showing that EDI treatment significantly reduces endothelial and sub-endothelial damage, lowers reactive oxygen species levels, increases oxidation-reduction potential, and enhances the expression of factors indicative of vascular protection. This suggests that EDI may have the potential to reduce graft disease and failure in patients undergoing CABG.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Medicine, General & Internal
Tzu-Hsiang Lin, Chi-Wei Wang, Ching-Hui Shen, Keng-Hao Chang, Chih-Hung Lai, Tsun-Jui Liu, Kuan-Ju Chen, Yu-Wei Chen, Wen-Lieng Lee, Chieh-Shou Su
Summary: The study found that in real-world practice, robotic-assisted CABG (R-CABG) for patients with multivessel coronary artery disease (MVD) was associated with lower in-hospital and long-term mortalities compared to conventional CABG (C-CABG). However, there were no significant differences between the two groups in terms of target lesion revascularization, target vessel revascularization, myocardial infarction, and stroke.
Review
Cardiac & Cardiovascular Systems
He Jiao, Jinghui Li, Yunpeng Bai, Zhigang Guo
Summary: This study compared the outcomes of sequential and individual saphenous vein grafts in coronary artery bypass grafting. The results showed that sequential grafts had higher rates of graft failure and long-term mortality, but also an increased risk of perioperative repeat revascularization. Based on the study, the selection of surgical techniques should be based on patients and surgeons.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Yu-Ting Cheng, Dong-Yi Chen, Victor Chien-Chia Wu, An-Hsun Chou, Shang-Hung Chang, Pao-Hsien Chu, Shao-Wei Chen
Summary: The effect of previous coronary stenting on subsequent coronary artery bypass graft is inconclusive. This retrospective study using Taiwan's National Health Insurance Database found that previous coronary stenting before multivessel coronary artery bypass graft significantly increased 30-day mortality but did not affect late survival. However, patients who had coronary stenting before coronary artery bypass graft experienced more revascularization events during late follow-up.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Donald S. Likosky, Raymond J. Strobel, Xiaoting Wu, Robert S. Kramer, Baron L. Hamman, James K. Brevig, Michael P. Thompson, Amir A. Ghaferi, Min Zhang, Eric J. Lehr
Summary: This study evaluated whether interhospital variation in mortality rates for coronary artery bypass grafting was driven by complications and failure to rescue. The study found a positive correlation between hospital failure to rescue rates and complications, suggesting that early recognition and management of complications are important factors in improving the success of coronary artery bypass grafting.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Psychology, Clinical
Wolfgang Linden, Sandra Young, Andrew Ignaszewski, Tavis Campbell
Summary: This study found that depression symptoms and household responsibility measured at 1-year post-CABG were significantly associated with long-term survival, with an interaction between depression symptoms and social support at year 1. Depression may contribute to increased event recurrence. Gender did not have a significant impact on long-term medical outcomes.
PSYCHOLOGICAL MEDICINE
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Grace Lee, Derrick Y. Tam, Stephen E. Fremes
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
N. Bryce Robinson, Hillary Lia, Mohamed Rahouma, Katia Audisio, Giovanni Soletti, Michelle Demetres, Jeremy R. Leonard, Stephen E. Fremes, Leonard N. Girardi, Mario Gaudino
Summary: The study aimed to investigate the impact of multiple arterial grafting on long-term all-cause mortality in women undergoing isolated coronary artery bypass grafting. The findings showed that women who received multiple arterial grafting had lower long-term mortality and spontaneous myocardial infarction compared to those who received single arterial grafting.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Derrick Y. Tam, Marc Ruel, Stephen E. Fremes
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Dominique Vervoort, Derrick Y. Tam, Stephen E. Fremes
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Kevin R. An, Veronica F. Chan, Stephen E. Fremes
ANNALS OF THORACIC SURGERY
(2023)
Review
Cardiac & Cardiovascular Systems
Grace Lee, Joanna Chikwe, Milan Milojevic, Harindra C. Wijeysundera, Giuseppe Biondi-Zoccai, Marcus Flather, Mario F. L. Gaudino, Stephen E. Fremes, Derrick Y. Tam
Summary: This review compares the latest European and American guidelines on the management of aortic stenosis (AS) and identifies three areas of divergence: timing of intervention, valve selection, and surgical vs. transcatheter aortic valve replacement criteria. Gaps in the literature for specific aspects of AS treatment are also highlighted.
EUROPEAN HEART JOURNAL
(2023)
Article
Surgery
Christian Stoppe, Bernard McDonald, Patrick Meybohm, Kenneth B. Christopher, Stephen Fremes, Richard Whitlock, Siamak Mohammadi, Dimitri Kalavrouziotis, Gunnar Elke, Rolf Rossaint, Philipp Helmer, Kai Zacharowski, Ulf Guenther, Matteo Parotto, Bernd Niemann, Andreas Boening, C. David Mazer, Philip M. Jones, Marion Ferner, Yoan Lamarche, Francois Lamontagne, Oliver J. Liakopoulos, Matthew Cameron, Matthias Mueller, Alexander Zarbock, Maria Wittmann, Andreas Goetzenich, Erich Kilger, Lutz Schomburg, Andrew G. Day, Daren K. Heyland
Summary: High-dose intravenous sodium selenite treatment did not reduce morbidity or mortality in high-risk cardiac surgery patients.
Article
Engineering, Biomedical
Nhien Tran-Nguyen, Andrew T. T. Yan, Stephen Fremes, Piero Triverio, Laura Jimenez-Juan
Summary: Coronary artery bypass graft surgery, a common treatment for coronary artery disease, can suffer from graft failure, and the underlying mechanisms are not fully understood. In this study, computational fluid dynamics simulations were used to investigate the relationship between graft hemodynamics and surgical outcomes. Results showed that abnormal wall shear stress (WSS) area one month after surgery correlated with graft lumen remodeling one year after surgery, suggesting that shear-related mechanisms may play a role in post-operative graft remodeling and explain differences in failure rates between arterial and venous grafts.
ANNALS OF BIOMEDICAL ENGINEERING
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Mario Gaudino, Stephen E. Fremes, Roxana Mehran, C. Noel Bairey Merz
Review
Medicine, General & Internal
Dominique Vervoort, Malak Elbatarny, Rodolfo Rocha, Stephen E. E. Fremes
Summary: Ischemic heart disease leads to high morbidity and mortality worldwide, often requiring coronary revascularization. Coronary artery bypass grafting (CABG) is a common surgical procedure using different bypass conduits. Saphenous vein grafts and left internal thoracic artery are commonly used for CABG. Multiple arterial grafting (MAG) is believed to be superior, but its adoption is limited due to technical complexity and lack of conclusive evidence from randomized controlled trials.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Mario Gaudino, Sigrid Sandner, Kevin R. An, Arnaldo Dimagli, Antonino Di Franco, Katia Audisio, Lamia Harik, Roberto Perezgrovas-Olaria, Giovanni Soletti, Stephen E. Fremes, David L. Hare, Alexander Kulik, Andre Lamy, Joyce Peper, Marc Ruel, Jurrien M. ten Berg, Laura M. Willemsen, Qiang Zhao, Daniel M. Wojdyla, Deepak L. Bhatt, John H. Alexander, Bjorn Redfors
Summary: Graft failure after CABG is common and strongly associated with adverse cardiac events. Age, female sex, and smoking are independent risk factors for graft failure, while statins have a protective effect. Graft failure is associated with an increased risk of myocardial infarction, repeat revascularization, and death.
Article
Cardiac & Cardiovascular Systems
Stephen Fremes, Guillaume Marquis-Gravel, Mario F. L. Gaudino, E. Marc Jolicoeur, Sylvain Bedard, Ruth Masterson Creber, Marc Ruel, Dominique C. Vervoort, Harindra E. Wijeysundera, Michael Farkouh, Jean-Lucien Rouleau
Summary: The STICH3C trial aims to compare the efficacy and safety of CABG and PCI in patients with iLVSD and multivessel disease. This trial will provide important evidence to guide clinical practice.
CIRCULATION-CARDIOVASCULAR INTERVENTIONS
(2023)
Review
Cardiac & Cardiovascular Systems
Robert A. Byrne, Stephen Fremes, Davide Capodanno, Martin Czerny, Torsten Doenst, Jonathan R. Emberson, Volkmar Falk, Mario Gaudino, John J. Mcmurray, Roxana Mehran, Milan Milojevic, Miguel Sousa Uva
Summary: In October 2021, the ESC and EACTS established a task force to review the 2018 guidelines on myocardial revascularization for patients with LM disease. The task force suggested updated recommendations for revascularization modality, stating that both CABG and PCI are clinically reasonable options for stable patients with LM disease. The task force also acknowledged knowledge gaps and emphasized the need for more data.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Salil V. Deo, Andrew Althouse, Sadeer Al-Kindi, David A. Mcallister, Ariela Orkaby, Yakov E. Elgudin, Stephen Fremes, Danny Chu, Frank L. J. Visseren, Jill P. Pell, Naveed Sattar
Summary: The SMART2 risk score performs well in coronary artery bypass grafting patients, with better predictive capabilities in patients with chronic kidney disease. However, it underestimates the incidence of major adverse cardiovascular events and shows differences in predictive ability between White and Black patients.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Review
Cardiac & Cardiovascular Systems
Robert A. Byrne, Stephen Fremes, Davide Capodanno, Martin Czerny, Torsten Doenst, Jonathan R. Emberson, Volkmar Falk, Mario Gaudino, John J. Mcmurray, Roxana Mehran, Milan Milojevic, Miguel Sousa Uva
Summary: In October 2021, the ESC and EACTS established a Task Force to review recommendations on myocardial revascularization in patients with LM disease. The TF assessed new data, including aggregated data from four randomized trials comparing PCI with CABG. The TF concluded that both treatment options are clinically reasonable based on patient preference, expertise, and local operator volumes, but acknowledged gaps in knowledge and the limitations of the available data.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)