Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week

Alistair Royse; Justin Ren; Colin Royse; David H. Tian; Stephen Fremes; Mario Gaudino; Umberto Benedetto; Y. Joseph Woo; Andrew B. Goldstone; Piroze Davierwala; Michael Borger; Michael Vallely; Christopher M. Reid; Rodolfo Rocha; David Glineur; Juan Grau; Richard Shaw; Hugh Paterson; Doa El-Ansary; Stuart Boggett; Nilesh Srivastav; Zulfayandi Pawanis; David Canty; Rinaldo Bellomo

doi:10.1016/j.jacc.2022.08.795

Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week

Alistair Royse, Justin Ren, Colin Royse, David H. Tian, Stephen Fremes, Mario Gaudino, Umberto Benedetto, Y. Joseph Woo, Andrew B. Goldstone, Piroze Davierwala, Michael Borger, Michael Vallely, Christopher M. Reid, Rodolfo Rocha, David Glineur, Juan Grau, Richard Shaw, Hugh Paterson, Doa El-Ansary, Stuart BoggettNilesh Srivastav, Zulfayandi Pawanis, David Canty, Rinaldo Bellomo

RSUA

Research output: Contribution to journal › Review article › peer-review

11 Citations (Scopus)

Abstract

Approximately 95% of patients of any age undergoing contemporary, coronary bypass surgery will receive at least 1 saphenous vein graft (SVG). It is recognized that SVG will develop progressive and accelerated atherosclerosis, resulting in a stenosis, and in occlusion that occurs in 50% by 10 years postoperatively. For arterial conduits, there is little evidence of progressive failure as for SVG. Could avoidance of SVG (total arterial revascularization [TAR]) lead to a different late (>5 year) survival? A literature review of 23 studies (N = 100,314 matched patients) at a mean 8.8 years postoperative found reduced all-cause mortality for TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a new unpublished data set (N = 63,288 matched patients) was combined with the literature review (N = 127,565). It found reduced all-cause mortality for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian analysis found a very high probability of a TAR-associated reduction all-cause mortality.

Original language	English
Pages (from-to)	1833-1843
Number of pages	11
Journal	Journal of the American College of Cardiology
Volume	80
Issue number	19
DOIs	https://doi.org/10.1016/j.jacc.2022.08.795
Publication status	Published - 8 Nov 2022

Keywords

CABG
SVG
TAR
meta-analysis
mortality
total arterial revascularization

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10.1016/j.jacc.2022.08.795

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Royse, A., Ren, J., Royse, C., Tian, D. H., Fremes, S., Gaudino, M., Benedetto, U., Woo, Y. J., Goldstone, A. B., Davierwala, P., Borger, M., Vallely, M., Reid, C. M., Rocha, R., Glineur, D., Grau, J., Shaw, R., Paterson, H., El-Ansary, D., ... Bellomo, R. (2022). Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week. Journal of the American College of Cardiology, 80(19), 1833-1843. https://doi.org/10.1016/j.jacc.2022.08.795

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title = "Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week",

abstract = "Approximately 95% of patients of any age undergoing contemporary, coronary bypass surgery will receive at least 1 saphenous vein graft (SVG). It is recognized that SVG will develop progressive and accelerated atherosclerosis, resulting in a stenosis, and in occlusion that occurs in 50% by 10 years postoperatively. For arterial conduits, there is little evidence of progressive failure as for SVG. Could avoidance of SVG (total arterial revascularization [TAR]) lead to a different late (>5 year) survival? A literature review of 23 studies (N = 100,314 matched patients) at a mean 8.8 years postoperative found reduced all-cause mortality for TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a new unpublished data set (N = 63,288 matched patients) was combined with the literature review (N = 127,565). It found reduced all-cause mortality for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian analysis found a very high probability of a TAR-associated reduction all-cause mortality.",

keywords = "CABG, SVG, TAR, meta-analysis, mortality, total arterial revascularization",

author = "Alistair Royse and Justin Ren and Colin Royse and Tian, {David H.} and Stephen Fremes and Mario Gaudino and Umberto Benedetto and Woo, {Y. Joseph} and Goldstone, {Andrew B.} and Piroze Davierwala and Michael Borger and Michael Vallely and Reid, {Christopher M.} and Rodolfo Rocha and David Glineur and Juan Grau and Richard Shaw and Hugh Paterson and Doa El-Ansary and Stuart Boggett and Nilesh Srivastav and Zulfayandi Pawanis and David Canty and Rinaldo Bellomo",

note = "Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = nov,

day = "8",

doi = "10.1016/j.jacc.2022.08.795",

language = "English",

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Royse, A, Ren, J, Royse, C, Tian, DH, Fremes, S, Gaudino, M, Benedetto, U, Woo, YJ, Goldstone, AB, Davierwala, P, Borger, M, Vallely, M, Reid, CM, Rocha, R, Glineur, D, Grau, J, Shaw, R, Paterson, H, El-Ansary, D, Boggett, S, Srivastav, N, Pawanis, Z, Canty, D & Bellomo, R 2022, 'Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week', Journal of the American College of Cardiology, vol. 80, no. 19, pp. 1833-1843. https://doi.org/10.1016/j.jacc.2022.08.795

TY - JOUR

T1 - Coronary Artery Bypass Surgery Without Saphenous Vein Grafting

T2 - JACC Review Topic of the Week

AU - Royse, Alistair

AU - Ren, Justin

AU - Royse, Colin

AU - Tian, David H.

AU - Fremes, Stephen

AU - Gaudino, Mario

AU - Benedetto, Umberto

AU - Woo, Y. Joseph

AU - Goldstone, Andrew B.

AU - Davierwala, Piroze

AU - Borger, Michael

AU - Vallely, Michael

AU - Reid, Christopher M.

AU - Rocha, Rodolfo

AU - Glineur, David

AU - Grau, Juan

AU - Shaw, Richard

AU - Paterson, Hugh

AU - El-Ansary, Doa

AU - Boggett, Stuart

AU - Srivastav, Nilesh

AU - Pawanis, Zulfayandi

AU - Canty, David

AU - Bellomo, Rinaldo

PY - 2022/11/8

Y1 - 2022/11/8

N2 - Approximately 95% of patients of any age undergoing contemporary, coronary bypass surgery will receive at least 1 saphenous vein graft (SVG). It is recognized that SVG will develop progressive and accelerated atherosclerosis, resulting in a stenosis, and in occlusion that occurs in 50% by 10 years postoperatively. For arterial conduits, there is little evidence of progressive failure as for SVG. Could avoidance of SVG (total arterial revascularization [TAR]) lead to a different late (>5 year) survival? A literature review of 23 studies (N = 100,314 matched patients) at a mean 8.8 years postoperative found reduced all-cause mortality for TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a new unpublished data set (N = 63,288 matched patients) was combined with the literature review (N = 127,565). It found reduced all-cause mortality for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian analysis found a very high probability of a TAR-associated reduction all-cause mortality.

AB - Approximately 95% of patients of any age undergoing contemporary, coronary bypass surgery will receive at least 1 saphenous vein graft (SVG). It is recognized that SVG will develop progressive and accelerated atherosclerosis, resulting in a stenosis, and in occlusion that occurs in 50% by 10 years postoperatively. For arterial conduits, there is little evidence of progressive failure as for SVG. Could avoidance of SVG (total arterial revascularization [TAR]) lead to a different late (>5 year) survival? A literature review of 23 studies (N = 100,314 matched patients) at a mean 8.8 years postoperative found reduced all-cause mortality for TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a new unpublished data set (N = 63,288 matched patients) was combined with the literature review (N = 127,565). It found reduced all-cause mortality for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian analysis found a very high probability of a TAR-associated reduction all-cause mortality.

KW - CABG

KW - SVG

KW - TAR

KW - meta-analysis

KW - mortality

KW - total arterial revascularization

UR - http://www.scopus.com/inward/record.url?scp=85140310369&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2022.08.795

DO - 10.1016/j.jacc.2022.08.795

M3 - Review article

AN - SCOPUS:85140310369

SN - 0735-1097

VL - 80

SP - 1833

EP - 1843

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 19

ER -

Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC Review Topic of the Week

Abstract

Keywords

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