For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
9
views
12
references
 Top references
cited by
7
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      288
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Minimally invasive direct coronary bypass compared with percutaneous coronary intervention for left anterior descending artery disease: a meta-analysis

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The clinical outcomes for left anterior descending (LAD) coronary artery lesion between minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) are still controversial. The objective was to compare safety and efficacy between MIDCAB and PCI for LAD.

          Methods

          Electronic databases and article references were systematically searched to access relevant studies. End points included mortality, myocardial infarction, target vessel revascularization (TVR), major adverse coronary events (MACE), angina recurrence, and stroke.

          Results

          Fourteen studies with 941 patients were finally involved in the present study. The mortality and incidence of myocardial infarction were similar in MIDCAB and PCI groups at 30 days, 6 months, and at follow-up beyond 1 year. Compared with PCI, MIDCAB decreased incidence of TVR and MACE at 6 months and beyond 1 year follow-up. MIDCAB was associated with a lower incidence of angina recurrence at 6 months compared with PCI. PCI was associated with higher risk of restenosis in target vessel. No significant difference was shown for stroke.

          Conclusion

          Our meta-analysis indicates that there are no significant differences in the safety between MIDCAB and PCI in patients with LAD. However MIDCAB is superior to PCI for TVR and MACE.

          Related collections

          Most cited references12

          • Record: found
          • Abstract: found
          • Article: not found

          Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery.

          Holger Thiele, Gerhard Schuler, P Sick … (2002)
          Minimally invasive bypass surgery and coronary-artery stenting are both accepted treatments for isolated stenosis of the proximal left anterior descending coronary artery. We compared the clinical outcomes after these two procedures. A total of 220 symptomatic patients with high-grade lesions in the proximal left anterior descending coronary artery were randomly assigned to treatment--110 to surgery and 110 to stenting. The combined clinical end point was freedom from major adverse cardiac events, such as death from cardiac causes, myocardial infarction, and the need for repeated revascularization of the target lesion within six months. A major adverse cardiac event occurred in 31 percent of patients after stenting, as compared with 15 percent in the surgery group (P=0.02). The difference was predominantly due to a higher rate of repeated revascularization of the target vessel for restenosis after stenting (29 percent vs. 8 percent, P=0.003). The combined rates of death and myocardial infarction did not differ significantly between groups (3 percent in the stenting group and 6 percent in the surgery group, P=0.50). Adverse events occurred more frequently after surgery. The percentage of patients free from angina after six months was 79 percent in the surgery group, as compared with 62 percent in the stenting group (P=0.03). In patients with isolated high-grade lesions of the proximal left anterior descending artery, both minimally invasive bypass surgery and stenting are effective. Stenting yields excellent short-term results with fewer periprocedural adverse events, but surgery is superior with regard to the need for repeated intervention in the target vessel and freedom from angina at six months of follow-up. Copyright 2002 Massachusetts Medical Society
          Article 0 comments Cited 23 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Drug-eluting versus bare-metal stents in unprotected left main coronary artery stenosis a meta-analysis.

            Sanjay Pandya, Young-Hak Kim, Sheridan Meyers … (2010)
            We undertook a meta-analysis to assess outcomes for drug-eluting stents (DES) and bare-metal stents (BMS) in percutaneous coronary intervention for unprotected left main coronary artery (ULMCA) stenosis. Uncertainty exists regarding the relative performance of DES versus BMS in percutaneous coronary intervention for unprotected left main coronary stenosis. Of a total of 838 studies, 44 met inclusion criteria (n = 10,342). The co-primary end points were mortality, myocardial infarction (MI), target vessel/lesion revascularization (TVR/TLR), and major adverse cardiac events (MACE: mortality, MI, TVR/TLR). Event rates for DES and BMS were calculated at 6 to 12 months, at 2 years, and at 3 years. Crude event rates at 3 years were mortality (8.8% and 12.7%), MI (4.0% and 3.4%), TVR/TLR (8.0% and 16.4%), and MACE (21.4% and 31.6%). Nine studies were included in a comparative analysis (n = 5,081). At 6 to 12 months the adjusted odds ratio (OR) for DES versus BMS were: mortality 0.94 (95% confidence interval [CI]: 0.06 to 15.48; p = 0.97), MI 0.64 (95% CI: 0.19 to 2.17; p = 0.47), TVR/TLR 0.10 (95% CI: 0.01 to 0.84; p = 0.01), and MACE 0.34 (95% CI: 0.15 to 0.78; p = 0.01). At 2 years, the OR for DES versus BMS were: mortality 0.42 (95% CI: 0.28 to 0.62; p < 0.01), MI 0.16 (95% CI: 0.01 to 3.53; p = 0.13), and MACE 0.31 (95% CI: 0.15 to 0.66; p < 0.01). At 3 years, the OR for DES versus BMS were: mortality 0.70 (95% CI: 0.53 to 0.92; p = 0.01), MI 0.49 (95% CI: 0.26 to 0.92; p = 0.03), TVR/TLR 0.46 (95% CI: 0.30 to 0.69; p < 0.01), and MACE 0.78 (95% CI: 0.57 to 1.07; p = 0.12). Our meta-analysis suggests that DES is associated with favorable outcomes for mortality, MI, TVR/TLR, and MACE as compared to BMS in percutaneous coronary intervention for unprotected left main coronary artery stenosis. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
            Article 0 comments Cited 11 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Percutaneous coronary intervention with drug-eluting stent implantation vs. minimally invasive direct coronary artery bypass (MIDCAB) in patients with left anterior descending coronary artery stenosis.

              Y. Oh, Hong Seog Seo, Myoung-Soon Hong … (2004)
              The aim of this study was to assess the effects of percutaneous coronary intervention with drug-eluting stents (DESs) versus minimally invasive direct coronary artery bypass (MIDCAB) surgery in the management of patients with proximal left anterior descending (LAD) coronary artery stenosis. Until recent years, despite the advantages of percutaneous transluminal coronary angioplasty (PTCA) with bare metal stent implantation, such as shorter hospital stays and recovery time, MIDCAB showed better results with regard to the need for repeated intervention in the target vessel than PTCA with proximal LAD lesions. Symptomatic patients (n = 189) were randomly assigned to DES group (n = 119) and MIDCAB group (n = 70). Patients with an isolated high-grade lesion (stenosis of > or = 70% of the luminal diameter) in the proximal LAD coronary artery (from the ostium to the first diagonal branch) were included in this study. During the 6-month follow-up period, 1.7% (n = 2) in the DES group needed repeated revascularization procedures for target lesion revascularization compared with 5.9% (n = 4) in the MIDCAB group (P = 0.196). The rates of death and myocardial infarction were similar in both groups [DES 0.0% (n = 0) vs. MIDCAB 2.9% (n = 2), P = 0.135; DES 1.7% (n = 2) vs. MIDCAB 2.9% (n = 2), P = 0.627; respectively] during 6 months of follow-up. In-hospital length of stay was significantly shorter in the DES group compared with the MIDCAB group (5.8 +/- 2.1 days vs. 8.9 +/- 2.6 days; P = 0.001). DES implantation and MIDCAB surgery showed similar rates of myocardial infarction, the need for repeated revascularization, and death during 6 months of follow-up. However, DES implantation resulted in lower average number of hospital stays and similar postoperative complications.
              Article 0 comments Cited 10 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Xiao-Wen Wang: wxwsurgery@163.com
                Can Qu: qcvivi2012@163.com
                Chun Huang: +86-023-89011132 , hcsurgery@163.com
                Xiao-Yong Xiang: cqmusurgery@163.com
                Zhi-Qian Lu: lzqsurgery@163.com
                Journal
                Journal ID (nlm-ta): J Cardiothorac Surg
                Journal ID (iso-abbrev): J Cardiothorac Surg
                Title: Journal of Cardiothoracic Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1749-8090
                Publication date (Electronic): 5 August 2016
                Publication date PMC-release: 5 August 2016
                Publication date Collection: 2016
                Volume: 11
                Electronic Location Identifier: 125
                Affiliations
                [1 ]Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
                [2 ]Department of Cardiothoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
                [3 ]Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
                Article
                Publisher ID: 512
                DOI: 10.1186/s13019-016-0512-1
                PMC ID: 4974706
                PubMed ID: 27491539
                SO-VID: 4ede8c25-0fd7-498e-85db-598a5bf58951
                Copyright © © The Author(s). 2016
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 9 November 2015
                Date accepted : 27 July 2016
                Funding
                Funded by: The Key Program of Health Bureau of Chongqing
                Award ID: 2013-1-015
                Award Recipient :
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2016

                ScienceOpen disciplines: Surgery
                Keywords: left anterior descending coronary artery,minimally invasive direct coronary artery bypass,percutaneous coronary intervention,outcome
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: left anterior descending coronary artery, minimally invasive direct coronary artery bypass, percutaneous coronary intervention, outcome

                Comments

                Comment on this article

                scite_

                Similar content288

                See all similar

                Cited by7

                See all cited by

                Most referenced authors173

                See all reference authors