Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.
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Sociedade Brasileira de Cirurgia Cardiovascular
2019
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oai:scielo:S0102-763820190002001422019-03-21Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS RegistryPaez,Rodrigo PereiraHossne Junior,Nelson AméricoSanto,José Amalth do EspíritoBerwanger,OtavioSantos,Renato Hideo NakagawaKalil,Renato Abdala KaramJatene,Fabio B.Cavalcanti,Alexandre BiasiZilli,Alexandre CabralBettiati Jr,Luiz CarlosFigueira,Fernando Augusto Marinho dos SantosD'Azevedo,Stephanie Steremberg PiresSoares,Marcelo José FerreiraFernandes,Marcio PimentelArdito,Roberto VitoBogdan,Renata Andrea BarberioCampagnucci,Valquíria PelisserNakasako,DianaRodrigues,Clarissa GarciaRodrigues Junior,Anilton BezerraCascudo,Marcelo MatosAtik,Fernando AntibasLima,Elson BorgesNina,Vinicius José da SilvaHeluy,Renato AlbuquerqueAzeredo,Lisandro GonçalvesHenrique Junior,Odilon SilvaMendonça,José Teles deSilva,Katharina Kelly de Oliveira GamaPandolfo,MarceloLima Júnior,José Dantas deFaria,Renato MaxSantos,Jonas Gonçalves dosCoelho,Guilherme Henrique BiachiPereira,Sergio NunesSenger,RobertaBuffolo,EnioCaputi,Guido MarcoOliveira,Juliana Aparecida Borges deGomes,Walter J. Registries Database, Cardiovascular Surgical Procedures Cardiac Surgical Procedures Coronary Artery Bypass Grafts Myocardial Revascularization Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.info:eu-repo/semantics/openAccessSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery v.34 n.2 20192019-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000200142en10.21470/1678-9741-2018-0313 |
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Paez,Rodrigo Pereira Hossne Junior,Nelson Américo Santo,José Amalth do Espírito Berwanger,Otavio Santos,Renato Hideo Nakagawa Kalil,Renato Abdala Karam Jatene,Fabio B. Cavalcanti,Alexandre Biasi Zilli,Alexandre Cabral Bettiati Jr,Luiz Carlos Figueira,Fernando Augusto Marinho dos Santos D'Azevedo,Stephanie Steremberg Pires Soares,Marcelo José Ferreira Fernandes,Marcio Pimentel Ardito,Roberto Vito Bogdan,Renata Andrea Barberio Campagnucci,Valquíria Pelisser Nakasako,Diana Rodrigues,Clarissa Garcia Rodrigues Junior,Anilton Bezerra Cascudo,Marcelo Matos Atik,Fernando Antibas Lima,Elson Borges Nina,Vinicius José da Silva Heluy,Renato Albuquerque Azeredo,Lisandro Gonçalves Henrique Junior,Odilon Silva Mendonça,José Teles de Silva,Katharina Kelly de Oliveira Gama Pandolfo,Marcelo Lima Júnior,José Dantas de Faria,Renato Max Santos,Jonas Gonçalves dos Coelho,Guilherme Henrique Biachi Pereira,Sergio Nunes Senger,Roberta Buffolo,Enio Caputi,Guido Marco Oliveira,Juliana Aparecida Borges de Gomes,Walter J. |
spellingShingle |
Paez,Rodrigo Pereira Hossne Junior,Nelson Américo Santo,José Amalth do Espírito Berwanger,Otavio Santos,Renato Hideo Nakagawa Kalil,Renato Abdala Karam Jatene,Fabio B. Cavalcanti,Alexandre Biasi Zilli,Alexandre Cabral Bettiati Jr,Luiz Carlos Figueira,Fernando Augusto Marinho dos Santos D'Azevedo,Stephanie Steremberg Pires Soares,Marcelo José Ferreira Fernandes,Marcio Pimentel Ardito,Roberto Vito Bogdan,Renata Andrea Barberio Campagnucci,Valquíria Pelisser Nakasako,Diana Rodrigues,Clarissa Garcia Rodrigues Junior,Anilton Bezerra Cascudo,Marcelo Matos Atik,Fernando Antibas Lima,Elson Borges Nina,Vinicius José da Silva Heluy,Renato Albuquerque Azeredo,Lisandro Gonçalves Henrique Junior,Odilon Silva Mendonça,José Teles de Silva,Katharina Kelly de Oliveira Gama Pandolfo,Marcelo Lima Júnior,José Dantas de Faria,Renato Max Santos,Jonas Gonçalves dos Coelho,Guilherme Henrique Biachi Pereira,Sergio Nunes Senger,Roberta Buffolo,Enio Caputi,Guido Marco Oliveira,Juliana Aparecida Borges de Gomes,Walter J. Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
author_facet |
Paez,Rodrigo Pereira Hossne Junior,Nelson Américo Santo,José Amalth do Espírito Berwanger,Otavio Santos,Renato Hideo Nakagawa Kalil,Renato Abdala Karam Jatene,Fabio B. Cavalcanti,Alexandre Biasi Zilli,Alexandre Cabral Bettiati Jr,Luiz Carlos Figueira,Fernando Augusto Marinho dos Santos D'Azevedo,Stephanie Steremberg Pires Soares,Marcelo José Ferreira Fernandes,Marcio Pimentel Ardito,Roberto Vito Bogdan,Renata Andrea Barberio Campagnucci,Valquíria Pelisser Nakasako,Diana Rodrigues,Clarissa Garcia Rodrigues Junior,Anilton Bezerra Cascudo,Marcelo Matos Atik,Fernando Antibas Lima,Elson Borges Nina,Vinicius José da Silva Heluy,Renato Albuquerque Azeredo,Lisandro Gonçalves Henrique Junior,Odilon Silva Mendonça,José Teles de Silva,Katharina Kelly de Oliveira Gama Pandolfo,Marcelo Lima Júnior,José Dantas de Faria,Renato Max Santos,Jonas Gonçalves dos Coelho,Guilherme Henrique Biachi Pereira,Sergio Nunes Senger,Roberta Buffolo,Enio Caputi,Guido Marco Oliveira,Juliana Aparecida Borges de Gomes,Walter J. |
author_sort |
Paez,Rodrigo Pereira |
title |
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
title_short |
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
title_full |
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
title_fullStr |
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
title_full_unstemmed |
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry |
title_sort |
coronary artery bypass surgery in brazil: analysis of the national reality through the bypass registry |
description |
Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country. |
publisher |
Sociedade Brasileira de Cirurgia Cardiovascular |
publishDate |
2019 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000200142 |
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