Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis.
Kawasaki disease
aorto-coronary bypass grafting
coronary artery aneurisms
surgical revascularization
Journal
Open medicine (Warsaw, Poland)
ISSN: 2391-5463
Titre abrégé: Open Med (Wars)
Pays: Poland
ID NLM: 101672167
Informations de publication
Date de publication:
2021
2021
Historique:
received:
06
11
2020
revised:
05
01
2021
accepted:
03
02
2021
entrez:
22
3
2021
pubmed:
23
3
2021
medline:
23
3
2021
Statut:
epublish
Résumé
Kawasaki disease (KD) is a systemic inflammatory condition occurring predominantly in children. Coronary artery bypass grafting (CABG) is performed in the presence of inflammation and aneurysms of the coronary arteries. The objectives of our study were to assess which CABG strategy provides better graft patency and early and long-term outcomes. A systematic review using Medline, Cochrane, and Scopus databases was performed in February 2020, incorporating a network meta-analysis, performed by random-effect model within a Bayesian framework, and pooled prevalence of adverse outcomes. Hazard ratios (HR) and corresponding 95% credible intervals (CI) were calculated by Markov chain Monte Carlo methods. Among 581 published reports, 32 studies were selected, including 1,191 patients undergoing CABG for KD. Graft patency of internal thoracic arteries (ITAs), saphenous veins (SV), and other arteries (gastroepiploic artery and radial artery) was compared. ITAs demonstrated the best patency rates at long-term follow-up (HR 0.33, 95% CI: 0.17-0.66). Pooled prevalence of early mortality after CABG was 0.28% (95% CI: 0.00-0.73%, CABG in KD is a safe procedure. The use of arterial conduits provides better patency rates and lower mortality at long-term follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
Kawasaki disease (KD) is a systemic inflammatory condition occurring predominantly in children. Coronary artery bypass grafting (CABG) is performed in the presence of inflammation and aneurysms of the coronary arteries. The objectives of our study were to assess which CABG strategy provides better graft patency and early and long-term outcomes.
METHODS
METHODS
A systematic review using Medline, Cochrane, and Scopus databases was performed in February 2020, incorporating a network meta-analysis, performed by random-effect model within a Bayesian framework, and pooled prevalence of adverse outcomes. Hazard ratios (HR) and corresponding 95% credible intervals (CI) were calculated by Markov chain Monte Carlo methods.
RESULTS
RESULTS
Among 581 published reports, 32 studies were selected, including 1,191 patients undergoing CABG for KD. Graft patency of internal thoracic arteries (ITAs), saphenous veins (SV), and other arteries (gastroepiploic artery and radial artery) was compared. ITAs demonstrated the best patency rates at long-term follow-up (HR 0.33, 95% CI: 0.17-0.66). Pooled prevalence of early mortality after CABG was 0.28% (95% CI: 0.00-0.73%,
CONCLUSIONS
CONCLUSIONS
CABG in KD is a safe procedure. The use of arterial conduits provides better patency rates and lower mortality at long-term follow-up.
Identifiants
pubmed: 33748422
doi: 10.1515/med-2021-0242
pii: med-2021-0242
pmc: PMC7957190
doi:
Types de publication
Journal Article
Langues
eng
Pagination
375-386Informations de copyright
© 2021 Antonio Salsano et al., published by De Gruyter.
Déclaration de conflit d'intérêts
Conflict of interest: Antonio Salsano declares to be Section Editor in Open Medicine, but this fact hasn't affected the peer-review process. The other coauthors state no conflict of interest.
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