Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (5): 26-32.doi: 10.6040/j.issn.1671-7554.0.2024.0805

• Special Topic on Application of Arterial Grafts in Coronary Artery Bypass Grafting • Previous Articles    

Multi-center clinical outcomes of fast-track extubation in total arterial coronary bypass grafting in China

GUO Ke, CHEN Xujun, ZHENG Baoshi, SHI Chao, HUANG Keli, CAO Yong, CHEN Jun, WU Dongkai, ZHANG Xiaoshen, LUO Junhui, SHEN Lin, MO Xumin, YANG Min, WANG Xiaowu, LEI Yinsheng, TIAN Maozhou, WANG Zhendong, MENG Zili, SUN Zhongdong, LI Youjin, LU Huihui, MENG Chunying, GAO Feng, CHEN Qiansu, GUO Nengrui, LIU Debin, ZHANG Nan, LIN Yu, CHEN Wensheng, SONG Baoguo, FANG Zhi, WANG Haichen, LIAO Xiaobo, XU Chaojun   

  • Published:2025-05-07

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Abstract: Objective To evaluate the safety and efficacy of fast-track extubation(FTE)in total arterial revascularization(TAR)in coronary bypass grafting(CABG)by a multi-center study. Methods The clinical data of all the patients who underwent TAR in 34 heart centers in China between January 2018 and May 2024 were retrospectively analyzed. The perioperative medical records and follow-up data of patients undergoing TAR with FTE(defined as extubation within 6 hours after surgery)were studied. Results Of 640 patients underwent TAR, a total of 221 patients(180 males and 41 females), with an age of(55.5±11.7)years, who accepted ETE, were included in this study. There were 171 cases of triple-vessel and 50 of double-vessel disease, with 70 of left main coronary artery lesions. Seventy-five patients had diabetes mellitus. All patients underwent TAR by on pump CABG. A total of 201 left internal mammary artery, 221 left radial artery, 200 right radial arteries, and 21 right internal mammary artery conduits were harvested to construct 612 single and 31 composite Y grafts. The number of distal anastomosis was 3.35±0.7. The time for tracheal intubation duration, ICU stay and postoperative hospital stay was(3.5±2.7)hours,(23.5±12.9)hours and(7.5±3.1)days, respectively. There was one surgical death. There was no other postoperative reintubation. Intra-aortic balloon pump was implanted in 17 patients. There were 22 patients with new-set atrial fibrillation, 11 with forearm hematoma, 13 with hypoxemia and 6 with acute renal insufficiency. No chest bone infection occurred. The follow-up duration was(54.3±7.5)months, with a follow-up rate of 90.91%. Compared to those of before operation, there was a significant improvement in left ventricular ejection fraction ［(60.0%±5.3%)vs.(55.1%±7.3%), t=11.16, P<0.001］ and an obvious decrease in left ventricular end diastolic diameter ［(51.6±2.2)mm vs.(55.0±7.5)mm, t=9.77, P<0.001］. All patients survived without major adverse cardiovascular and cerebrovascular event during follow-up. Conclusion This study suggests that FTE in TAR appears to be safe and effective.

Key words: Coronary artery bypass grafting, Total arterialization revascularization, Fast-track extubation, Multi-center, Clinical outcomes

CLC Number: 

  • R654
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