Alpha 2.0
Login Register
» Articles » PMID: 33642713

Impact of Avoiding Cardioplegic Arrest on Clinical Outcome in Patients Undergoing CABG in Bangladesh: a Systematic Review and Meta-analysis

Overview
Journal Indian J Thorac Cardiovasc Surg
Publisher Springer
Date 2021 Mar 1
PMID 33642713
Authors
Faizus Sazzad
Geetha Ganesh
Prashasth Cheekoty
Muthu Veerappan
Theo Kofidis
Affiliations
Soon will be listed here.
Abstract

Objectives: Over the last decade, the practice of surgical revascularization for the coronary artery disease has been popularized in Bangladesh. Our aim was to compare the outcome of non-cardioplegic versus cardioplegic coronary artery bypass surgery in terms of early postoperative outcomes.

Methods: A literature search was conducted in March 2020 on Medline (via PubMed), Scopus and Bangladesh Journal Online electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. All randomized controlled trials and observational studies reporting findings of coronary revascularization surgery comparing the outcomes were included.

Results: Fifteen studies were used quantitatively that included a total cohort of 4750 coronary artery bypass graft (CABG) patients in Bangladesh. After the meta-analysis, we observed a longer duration of operating time [mean difference (MD): - 52.30, confidence interval (CI): - 67.73 to - 36.86, 18 = 89%,  < 0.00001] and a higher incidence of postoperative atrial fibrillation [risk ratio (RR): 0.43, CI: 0.14 to 0.80,  = 44%,  = 0.01] in the cardioplegic CABG group as compared with the non-cardioplegic group. Additionally, statistically significant longer duration of ventilation time (MD: - 8.64, CI: - 9.47 to - 7.82,  = 82%,  < 0.00001) and ICU stay (MD: - 17.25, CI: - 33.36 to - 1.14,  = 99%,  = 0.04) was observed in the cardioplegic group. No significant differences in number of grafts and in-hospital mortality were found between the two groups.

Conclusion: Non-cardioplegic CABG may be a viable alternative to cardioplegic CABG in Bangladeshi population, providing similar postoperative outcomes but offering additional advantage of shorter operation and ventilation times.

References
1.
Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4):264-9, W64. DOI: 10.7326/0003-4819-151-4-200908180-00135. View
2.
Ranjan R, Adhikary D, Mandal S, Saha S, Hasan K, Adhikary A . Performance of EuroSCORE II and logistic EuroSCORE in Bangladeshi population undergoing off-pump coronary artery bypass surgery: A prospective cohort study. JRSM Cardiovasc Dis. 2019; 8:2048004019862125. PMC: 6613058. DOI: 10.1177/2048004019862125. View
3.
Jadad A, Moore R, Carroll D, Jenkinson C, Reynolds D, Gavaghan D . Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996; 17(1):1-12. DOI: 10.1016/0197-2456(95)00134-4. View
4.
Hosain N, Amin F, Rehman S, Koirala B . Know thy neighbors: The status of cardiac surgery in the South Asian countries around India. Indian Heart J. 2017; 69(6):790-796. PMC: 5717308. DOI: 10.1016/j.ihj.2017.09.219. View
5.
Ueki C, Sakaguchi G, Akimoto T, Ohashi Y, Sato H . On-pump beating-heart technique is associated with lower morbidity and mortality following coronary artery bypass grafting: a meta-analysis. Eur J Cardiothorac Surg. 2016; 50(5):813-821. DOI: 10.1093/ejcts/ezw129. View