Systematic Review and Pooled Meta-analysis of the Current Status of Coronary Revascularization Surgery in Bangladesh

Authors

  • Faizus Sazzad Research Fellow/Cardiac Surgeon, Assistant Director, Cardiac Surgery Experimental Lab, Cardiovascular Research Institute (CVRI), National University of Singapore, Singapore
  • Ashlynn Ai Li Ler Research Intern, Cardiac Surgery Experimental Lab, NUS, Singapore and School of Medicine, National University of Ireland, Galway, Ireland
  • Geetha Ganesh Consultant, Cardiac Surgery Experimental Lab, National University of Singapore, Singapore and Indian Institute of Technology Madras, Chennai, India
  • Marcus Kung School of Biomedical Engineering, Temasek Polytechnique, Singapore
  • Theo Kofidis Chairman, Initiative for Research and Innovation of Surgery, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and Head & Senior Consultant, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore

DOI:

https://doi.org/10.3329/bhj.v35i2.52894

Keywords:

BECAB: Beating heart coronary artery bypass surgery; CCAB: Conventional coronary artery bypass surgery; Coronary Artery Bypass, Bangladesh

Abstract

Background: There is no consensus on the role of beating heart coronary artery bypass graft surgery (BECAB) in adult Bangladeshi patients requiring coronary revascularization surgery. We aimed to conduct a systematic review on all literature related to BECAB and/or conventional (CCAB) to determine the comparability of the patient outcomes of BECAB with that of a controlled cohort.

Method: We carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A meta-analysis was conducted to compare clinical outcomes between the BECAB and CCAB cohorts. Pooled analyses were also performed to determine the incidence rates of any adverse outcomes related to CABG.

Results: We observed significantly lower rates of operation time (MD: -52.30, CI: -67.73 to -36.86, p<0.0001), ventilation time (MD: -8.64, CI: -9.47 to -7.82, p<0.0001) and ICU stay (MD: -17.47, CI: -33.57 to -1.38, p=0.03) associated with BECAB. From our pooled analyses of the BECAB cohort, we observed that the average blood loss was 500.303 [352.099, 648.507], while the average rates of perioperative MI (0.020 [0.002, 0.049]), stroke/TIA (0.015 [0.000, 0.042]), AKI (0.006 [0.002, 0.012]), respiratory complications (0.020 [0.000, 0.058]) and low output syndrome (0.123 [0.106, 0.141]) were all lower than the averages observed in the CCAB cohort.

Conclusion: In an adult Bangladeshi CABG population, the clinical outcomes of patients that underwent BECAB were non-inferior to, if not better than, patients who underwent CCAB.

Bangladesh Heart Journal 2020; 35(2) : 87-99

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Published

2021-04-07

How to Cite

Sazzad, F., Ler, A. A. L., Ganesh, G., Kung, M., & Kofidis, T. (2021). Systematic Review and Pooled Meta-analysis of the Current Status of Coronary Revascularization Surgery in Bangladesh. Bangladesh Heart Journal, 35(2), 87–99. https://doi.org/10.3329/bhj.v35i2.52894

Issue

Vol. 35 No. 2 (2020)

Section

Original Articles

License

© Bangladesh Cardiac Society.  

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Articles in the Bangladesh Heart Journal are Open Access articles published under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC).  This license permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.