Percutaneous coronary intervention versus coronary artery bypass grafting in heart transplant recipients with coronary allograft vasculopathy: a systematic review and meta-analysis of 1,520 patients

Annals of Cardiothoracic Surgery
Jessica G Y LucVakhtang Tchantchaleishvili

Abstract

Transplant coronary artery vasculopathy (TCAV) is the major cause of late allograft failure and death in heart transplant recipients. The aim of this systematic review was to examine the outcomes of percutaneous coronary interventions (PCIs) as compared to coronary artery bypass grafting (CABG) surgery in the management of TCAV. Our secondary objective was to compare the use and outcomes of drug eluting stents (DES) as compared to bare metal stents (BMS) in this patient population. Electronic search was performed to identify all studies in the English literature examining PCI as compared to CABG for TCAV in heart transplant recipients. All identified articles were systematically assessed for inclusion and exclusion criteria. Of the 4,989 studies identified, 29 studies were included. Among 1,520 patients who developed TCAV, 1,470 patients underwent PCI and 50 patients underwent CABG. There were no significant differences in baseline demographics and comorbidities among the PCI and CABG cohorts. Compared to the PCI cohort, patients who underwent CABG had a higher early mortality (CABG 36.4%vs. PCI 4.3%, P<0.001) and overall mortality (CABG 42.3%vs. PCI 21.4%, P=0.049). When comparing DES versus BMS cohorts, there were no signific...Continue Reading

Citations

Jan 29, 2020·Clinical Transplantation·Felicity LeeSharon Chih
Mar 19, 2019·Transplantation·Andriana P Nikolova, Jon A Kobashigawa
Sep 14, 2018·Heart·Sai Kiran BhagraJayan Parameshwar
Aug 14, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Harshil ShahAchint Patel
Sep 11, 2019·European Heart Journal·Juhani KnuutiUNKNOWN ESC Scientific Document Group
Jun 27, 2019·Transplantation·Andriana P Nikolova, Jon A Kobashigawa
Oct 17, 2020·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Sai Bhagra, Jayan Parameshwar
Nov 12, 2020·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Sidhi LaksonoSteven Philip Surya
Aug 4, 2021·Cardiovascular Research·Jordan S PoberGeorge Tellides

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