Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
Year: 2019
Type: article
Study design: Observational Study
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.
Authors: Rodrigo Pereira Paez, Nelson Américo Hossne Junior, José Amalth do Espírito Santo, Otavio Berwanger, Renato Hideo Nakagawa Santos, Renato Abdala Karam Kalil, Fábio B. Jatene, Alexandre Biasi Cavalcanti, Alexandre Cabral Zilli, Luiz Carlos Bettiati Jr, Fernando Augusto Marinho dos Santos Figueira, Stephanie Steremberg Pires D’Azevedo, Marcelo José Ferreira Soares, Marcio Pimentel Fernandes, Roberto Vito Ardito, Renata Andrea Barberio Bogdan, Valquíria Pelisser Campagnucci, Diana Nakasako, Clarissa Garcia Rodrigues, Anilton Bezerra Rodrigues Junior, Marcelo Matos Cascudo, Fernando Antibas Atik, Elson Borges Lima, Vinícius José da Silva Nina, Renato Albuquerque Heluy, Lisandro Gonçalves Azeredo, Odilon Silva Henrique Junior, José Teles de Mendonça, Katharina Kelly de Oliveira Gama Silva, Marcelo Pandolfo, José Dantas de Lima Júnior, Renato Max Faria, Jonas Gonçalves dos Santos, Guilherme Henrique Biachi Coelho, Sergio Nunes Pereira, Roberta Senger, Enio Buffolo, Guido Marco Caputi, Juliana Aparecida Borges de Oliveira, Walter J. Gomes
Institutions: Hospital São Paulo, Universidade Federal de São Paulo, Hospital do Coração, Fundação Universitária de Cardiologia, Instituto do Coração - HCFMUSP, Instituto de Medicina Integral Professor Fernando Figueira, Faculdade de Medicina de São José do Rio Preto, Hospital de Base, Instituto de Moléstias Cardiovasculares, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Instituto de Cardiologia do Distrito Federal, Hospital Universitário da Universidade Federal do Maranhão, Hospital do Rocio, Hospital Universitário de Santa Maria
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2922816166