Universität zu Köln

Diab, Mahmoud, Lehmann, Thomas, Weber, Carolyn, Petrov, Georgi, Luehr, Maximilian, Akhyari, Payam ORCID: 0000-0002-6452-8678, Tugtekin, Sems-Malte, Schulze, P. Christian, Franz, Marcus ORCID: 0000-0001-6543-4684, Misfeld, Martin, Borger, Michael A., Matschke, Klaus, Wahlers, Thorsten, Lichtenberg, Artur, Hagl, Christian and Doenst, Torsten (2021). Role of Concomitant Coronary Artery Bypass Grafting in Valve Surgery for Infective Endocarditis. J. Clin. Med., 10 (13). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: It is current practice to perform concomitant coronary artery bypass grafting (CABG) in patients with infective endocarditis (IE) who have relevant coronary artery disease (CAD). However, CABG may add complexity to the operation. We aimed to investigate the impact of concomitant CABG on perioperative outcomes in patients undergoing surgery for IE. Methods: We retrospectively used data of surgically treated IE patients between 1994 and 2018 in six German cardiac surgery centers. We performed inverse probability weighting (IPW), multivariable adjustment, chi-square analysis, and Kaplan-Meier survival estimates. Results: CAD was reported in 1242/4917 (25%) patients. Among them, 527 received concomitant CABG. After adjustment for basal characteristics between CABG and no-CABG patients using IPW, concomitant CABG was associated with higher postoperative stroke (26% vs. 21%, p = 0.003) and a trend towards higher postoperative hemodialysis (29% vs. 25%, p = 0.052). Thirty-day mortality was similar in both groups (24% vs. 23%, p = 0.370). Multivariate Cox regression analysis after IPW showed that CABG was not associated with better long-term survival (HR: 1.00, 95% CI: 0.82-1.23, p = 0.998). Conclusion: In endocarditis patients with CAD, adding CABG to valve surgery may be associated with a higher likelihood of postoperative stroke without adding long-term survival benefits. Therefore, in the absence of critical CAD, concomitant CABG may be omitted without impacting outcome. The results are limited due to a lack of data on the severity of CAD, and therefore there is a need for a randomized trial.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Diab, Mahmoud UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrov, Georgi UNSPECIFIED UNSPECIFIED UNSPECIFIED Luehr, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Akhyari, Payam UNSPECIFIED orcid.org/0000-0002-6452-8678 UNSPECIFIED Tugtekin, Sems-Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulze, P. Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Franz, Marcus UNSPECIFIED orcid.org/0000-0001-6543-4684 UNSPECIFIED Misfeld, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Borger, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Matschke, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenberg, Artur UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagl, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Doenst, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-595157
DOI:	10.3390/jcm10132867
Journal or Publication Title:	J. Clin. Med.
Volume:	10
Number:	13
Date:	2021
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2077-0383
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM SURVIVAL; DISEASE; REPLACEMENT; MORTALITY; IMPACT; OUTCOMES Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59515