Outcomes of coronary artery bypass graft surgery

Anna Louise Hawkes, Madeleine Nowak, Benjamin Bidstrup, Richard Speare, Anna Louise Hawkes, Madeleine Nowak, Benjamin Bidstrup, Richard Speare

Abstract

This review article summarizes the major studies that have investigated the outcomes of coronary artery bypass graft surgery (CABG). The article includes a review of the literature in the areas of: history of CABG; indications for CABG; and measurement of quality of life following CABG, including prolongation of life, physical functioning (ie, relief from angina and dyspnea, physical activity, as well as complications of surgery and re-hospitalization), psychological functioning, and social functioning. Overall, the literature demonstrates that the outcomes of CABG have historically been measured in terms of mortality and morbidity; however, it has now been well recognized that adjustment to CABG is a multidimensional phenomenon that is not fully explained by medical factors. Therefore, in addition to studying mortality and morbidity outcomes following CABG many recent studies have identified that it is important to investigate various physical, psychological, and social variables that have a significant impact on post-operative adjustment to CABG.

References

    1. Australian Institute of Health and Welfare (AIHW) and National Heart Foundation of Australia (NHFA) Heart, stroke and vascular diseases–Australian facts 2004. 2004. Canberra, National Centre for monitoring cardiovascular disease: 140.
    1. Allen JK. Physical and psychosocial outcomes after coronary artery bypass graft surgery: review of the literature. Heart & Lung. 1990;19:49–55.
    1. Bakhai A, Hill RA, Dundar Y, et al. Percutaneous transluminal coronary angioplasty with stents versus coronary artery bypass grafting for people with stable angina or acute coronary syndromes. The Cochrane Database of Systematic Reviews. 2005;(Issue 1)
    1. Boudrez H, Backer G. Psychological status and the role of coping style after coronary artery bypass surgery. Results of a prospective study. Qual Life Res. 2001;10:37–47.
    1. Buxton BF, Komeda M, Fuller JA, et al. Bilateral internal thoracic artery grafting may improve outcome of coronary artery surgery-Risk-adjusted survival. Circulation. 1998;98(Suppl):II1–6.
    1. Caine N, Harrison SC, Sharples LD, et al. Prospective study of quality of life before and after coronary artery bypass grafting. Br Med J. 1991;302(6775):511–16.
    1. Caines AE, Massad MG, Kpodonu J, et al. Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention and medical therapy for multivessel disease with and without left ventricular dysfunction. Cardiology. 2004;101:21–8.
    1. Calafiore AM, Contini M, Vitolla G, et al. Bilateral internal thoracic artery grafting: long-term clinical and angiographic results of in situ versus Y grafts. J Thorac Cardiovasc Surg. 2000;120:990–8.
    1. Cameron A, Davis KB, Green G, et al. Coronary bypass surgery with internal-thoracic-artery grafts: effects on survival over a 15-year period. N Engl J Med. 1996;334:216–19.
    1. Coronary Artery Surgery Study (CASS) Principle Investigators. Coronary artery surgery study (CASS):a randomized trial of coronary artery bypass surgery. Quality of life in patients randomly assigned to treatment groups. Circulation. 1983;68:951–60.
    1. Chocron S, Etievent JP, Viel JF, et al. Prospective study of quality of life before and after open heart operations. Ann Thorac Surg. 1996;61:153–7.
    1. Cundiff DK. Coronary artery bypass grafting (CABGS): reassessing efficacy, safety and cost. Med Gen Med. 2002;4:7.
    1. Damgaard S, Steinbruchel DA, Kjaergard HK. An update on internal mammary artery grafting for coronary artery disease. Curr Opin Cardiol. 2005;20:521–4.
    1. Dion R, Glineur D, Derouck D, et al. Long-term and angiographic follow up of sequential internal thoracic artery grafting. Eur J Cardiothorac Surg. 2000;17:407–14.
    1. Duits AA, Boeke S, Taams MA, et al. Prediction of quality of life after coronary artery bypass graft surgery: a review and evaluation of multiple, recent studies. Psychosom Med. 1997;59:257–68.
    1. Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: executive summary and recommendations. A report of the American College of cardiology/American Heart Association Task Force on Practice Gidelines (Committee to revise the 1991 guidelines for coronary artery bypass graft surgery) Circulation. 1999;100:1464–80.
    1. European Coronary Surgery Study Group. European Coronary Surgery Study Group: Long-term results of prospective randomised study of coronary artery bypass surgery in stable angina pectoris. Lancet. 1982;2:1173–80.
    1. Fasken LL, Wipke-Tevis DD, Sagehorn KK. Factors associated with unplanned readmission following cardiac surgery. Prog Cardiacvasc Nurs. 2001;16:107–15.
    1. Ferguson TB, Hammill BG, Peterson ED, et al. A decade of change–risk profiles and outcomes for isolated coronary artery bypass grafting procedures, 1990–1999: a report from the STS National Database Committee and the Dukes Clinical Research Institute. Society of Thoracic Surgeons. Ann Thorac Surg. 2002;73:480–90.
    1. Fihn SD, Williams SV, Daley J, et al. Guidlines for the management of patients with chronic stable angina: treatment. Ann Intern Med. 2001;135:616–632.
    1. Fitzgibbon GM, Kafka HA, Leach HA. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival in reoperation in 1,388 patients during 25 years. J Am Coll Cardiol. 1996;28:616–26.
    1. Gardner FV, Worwood EV. Psychological effects of cardiac surgery: a review of the literature. J R Soc Health. 1997;117:245–9.
    1. Geissler B, Aggestrup S. Qualitative assessment of pain relief and functional improvement after coronary bypass surgery. A questionnaire survey among 527 patients. Ugeskr Laeger. 2002;164:1506–10.
    1. Grover FL, Hammermeister KE, Burchfiel C. Initial report of the Veterans Administration Preoperative Risk Assessment Study for Cardiac Surgery. Ann Thorac Surg. 1990;50:12–26. discussion 27–18.
    1. Hampton J. Coronary artery bypass grafting for the reduction of mortality: an analysis of the trials. Br Med J. 1984;289:1166–1170.
    1. Herlitz J, Karlson BW, Sjoland H, et al. Physical activity, symptoms of chest pain and dyspnea in patients with ischemic heart disease in relation to age before and two years after coronary artery bypass grafting. J Cardiovasc Surg. 2001;42(2):165–173.
    1. Hlatky MA, Boothroyd D, Horine S, et al. Employment after coronary angioplasty or coronary bypass surgery in patients at the time of revascularisation. Ann Intern Med. 1998;129:543–7.
    1. Hlatky MA, Boothroyd DB, Melsop KA, et al. Medical costs and quality of life 10 to 12 years after randomisation to angioplasty or bypass surgery for multivessel coronary artery disease. Circulation. 2004;110:1960–6.
    1. Jenkins CD, Stanton BA, Savageau JA, et al. Coronary artery bypass surgey. Physical, psychological, social and economic outcomes six months later. JAMA. 1983;250:782–8.
    1. Jue NH, Cunningham SL. Stages of exercise behaviour change at two time periods following coronary artery bypass graft surgery. Prog Cardiovasc Nurs. 1998;13:23–33.
    1. Kaul TK, Fields BL, Wyatt DA, et al. Reoperative coronary artery bypass. Surg (Torino) 1995;36:303–12.
    1. Keogh B, Kinsman R. Fifth national adult cardiac surgical database report 2003: improving outcomes for patients. Oxfordshire UK: Dendrite Clinical Systems; 2004.
    1. Kirklin JW, Frye RL, Blackstone EH. Some comments on the indications for the coronary artery bypass graft operation. Int J Cardiol. 1991;31:23–30.
    1. Lett HS, Blumenthal JA, Babyak MA, et al. Social support and coronary heart disease: epidemiologic evidence and implications for treatment. Psychosom Med. 2005;67:869–78.
    1. Loop FD, Lytle BW, Cosgrove DM, et al. Influence of the internal thoracic artery graft on 10-year survival and other cardiac events. N Engl J Med. 1986;314:1–6.
    1. Lytle BW, Blackstone EH, Loop FD, et al. Two internal thoracic artery grafts are better than one. J Thorac Cardiovasc Surg. 1999;117:885–72.
    1. Magni G, Unger HP, Valfre C, et al. Psychosocial outcome one year after heart surgery. A prospective study. Arch Intern Med. 1987;147:473–7.
    1. Mayou R, Bryant B. Quality of life after coronary artery surgery. Q J Med. 1987;62:239–48.
    1. McCarthy MJ, Jr, Shroyer AL, Sethi GK, et al. Self-report measures for assessing treatment outcomes in cardiac surgery patients. Med Care. 1995;33(Suppl10):OS76–85.
    1. McDowell I, Newell C. Measuring Health: A guide to rating scales and questionnaires. Oxford: Oxford University Press; 1996.
    1. Mittag W, Schwarzer R. Interaction of employment status and self-efficacy on alcohol consumption: a two-wave study on stressful life transitions. Psychology and Health. 1993;8:77–87.
    1. Newman MF, Grocott HP, Mathew JP, et al. Neurologic Outcome Research Group and the Cardiothoracic Anesthesia Research Endeavors (CARE) Investigators of the Duke Heart Center. Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery. Stroke. 2001;32:2874–81.
    1. Orth-Gomer K, Horsten M, Wamala SP, et al. Social relations and extent and severity of coronary artery disease. The Stockholm Female Coronary Risk Study. Eur Heart J. 1998;19:1648–56.
    1. Pepper J. Controversies in off-pump coronary artery surgery. Clin Med Res. 2005;3:27–33.
    1. Phillips-Bute B, Mathew JP, Blumenthal JA, et al. Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery. Psychosom Med. 2006;68:369–75.
    1. Pick AW, Orszulak TA, Anderson BJ, et al. Single versus bilateral internal mammary artery grafts: 10-year outcome analysis. Ann Thorac Surg. 1997;64:599–605.
    1. Pollick C. Coronary artery bypass surgery. Which patient benefits? Can Fam Physician. 1993;39:318–23.
    1. Raja PV, Blumenthal JA, Doraiswamy PM. Cognitive deficits following coronary artery bypass grafting: prevalence, prognosis, and therapeutic strategies. CNS Spectr. 2004;9:763–72.
    1. Ross AC, Ostrow L. Subjectively perceived quality of life after coronary artery bypass surgery. Am J Crit Care. 2001;10:11–16.
    1. Schmidt SE, Jones JW, Thornby JI, et al. Improved survival with multiple left–sided bilateral internal thoracic artery grafts. Ann Thorac Surg. 1997;64:9–15.
    1. Senes-Ferrari S. Cardiac Surgery in Australia 1994. Canberra: Australian Institute of Health and Welfare. Australian Goverment Publishing Service; 1999.
    1. Serruys PW, Ong AT, Van Herwerden LA, et al. Five-year outcomes after coronary stenting versus bypass surgery for the treatment of multivessel disease: the final analysis of the Arterial Revascularization Therapies Study (ARTS) randomized trial. J Am Coll Cardiol. 2005;46:589–91.
    1. Sjoland H, Caidahl K, Karlson BW, et al. Limitation of physical activity, dyspnea and chest pain before and two years after coronary artery bypass grafting in relation to sex. Int J Cardiol. 1997a;61:123–33.
    1. Sjoland H, Caidahl K, Wiklund I, et al. Impact of coronary artery bypass grafting on various aspects of quality of life. Eur J Cardiothorac Surg. 1997b;12:612–19.
    1. Skinner JS, Farrer M, Albers CJ, et al. Patient-related outcomes five years after coronary artery bypass graft surgery. QJM. 1999;92:87–96.
    1. Solomon AJ, Gersh BJ. Management of chronic stable angina: medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft surgery. Lessons from the randomised trials. Ann Intern Med. 1998;128:216–23.
    1. Spargias KS, Cokkinos DV. Medical versus interventional management of stable angina. Coron Artery Dis. 2004;15(Suppl 1):S5–10.
    1. Stanton BA, Jenkins CD, Goldstein RL, et al. Hospital readmissions among survivors six months after myocardial revascularization. JAMA. 1985;253:3568–73.
    1. Taggart DP, D’Amico R, Altman DG. The effect of arterial revascularisation on survival: review of studies comparing bilateral and single internal mammary arteries. Lancet. 2001;358:870–875.
    1. Timberlake N, Klinger L, Smith P, et al. Incidence and patterns of depression following coronary artery bypass graft surgery. J Psychosom Res. 1997;43:197–207.
    1. Van Dijk D, Jansen EW, Hijman R, et al. Cognitive outcome after off- pump and on- pump coronary artery bypass graft surgery: a randomised trial. JAMA. 2002;287:1405–12.
    1. Weintraub WS, Jones EL, Craver JM, et al. Frequency of repeat coronary bypass or coronary angioplasty after coronary artery bypass surgery using saphenous vein grafts. Am J Cardiol. 1994;73:103–12.
    1. Wenger NK, Froelicher ES, Smith LK, et al. Cardiac Rehabilitation. Clinical Practice Guidline No. 17. Rockville MD: US Department of Health and Human Services. Public Health Service. Agency for Health Care Policy and Research and National Heart, Lung and Blood Institute; AHCPR; 1995.
    1. Wilson-Barnett J. Assessment of recovery: with special reference to a study with post-operative cardiac patients. J Adv Nurs. 1981;6:435–45.
    1. Wise M, Graham-Clarke P. Cardiovascular health in Australia: A review of current activities and future directions. Canberra: Department Human Services and Health. Australian Government Publishing Services; 1994.
    1. Wolman RL, Nussmeier NA, Aggarwal A, et al. Cerebral injury after cardiac surgery: identification of a group at extraordinary risk. Multicenter Study of Perioperative Ischemia Research Group (McSPI) and the Ischemia Research Education Foundation (IREF) Investigators. Stroke. 1999:514–22.
    1. Wortman PM, Yeaton WH. Cumulating quality of life results in controlled trials of coronary artery bypass graft surgery. Control Clin Trials. 1985;6:289–305.
    1. Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994;344:563–70.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera