Hybrid coronary revascularization versus conventional coronary artery bypass grafting: Systematic review and meta-analysis

被引:32
作者
Reynolds, Alexander C. [1 ]
King, Nicola [1 ]
机构
[1] Univ Plymouth, Sch Biomed & Healthcare Sci, Plymouth PL4 8AA, Devon, England
关键词
blood transfusion; cardiac surgery; coronary artery disease; hospital costs; percutaneous coronary intervention; OFF-PUMP; FOLLOW-UP; CARDIAC-SURGERY; ON-PUMP; DISEASE; INTERVENTION; OUTCOMES; ANGIOPLASTY; SYNTAX; BIAS;
D O I
10.1097/MD.0000000000011941
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background:Hybrid coronary revascularization (HCR) combining minimally invasive grafting of the left internal mammary artery to the left anterior descending artery with percutaneous coronary intervention has become a viable option for treating coronary artery disease. The aim of this meta-analysis was to compare HCR with conventional coronary artery bypass grafting (CABG) in a range of clinical outcomes and hospital costs.Methods:To identify potential studies, systematic searches were carried out in various databases. The key search terms included hybrid revascularization AND coronary artery bypass grafting OR HCR OR CABG. This was followed by a meta-analysis investigating the need for blood transfusion, hospital costs, ventilation time, hospital stay, cerebrovascular accident, myocardial infarction, mortality, postoperative atrial fibrillation, renal failure, operation duration, and ICU stay.Results:The requirement for blood transfusion was significantly lower for HCR: odds ratio 0.38 (95% confidence intervals [CIs] 0.31-0.46, P<.00001) as was the hospital stay: mean difference (MD) -1.48 days (95% CI, -2.61 to -0.36, P=0.01) and the ventilation time: MD -8.99hours (95% CI, -15.85 to -2.13, P=.01). On the contrary, hospital costs were more expensive for HCR: MD $3970 (95% CI, 2570-5370, P<.00001). All other comparisons were insignificant.Conclusions:In the short-term, HCR is as safe as conventional CABG and may offer certain benefits such as a lower requirement for blood transfusion and shorter hospital stays. However, HCR is more expensive than conventional CABG.
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页数:8
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