title: Trends in isolated coronary artery bypass grafting over the last decade.
abstract: The purpose of this study was to assess the impact on hospital mortality and morbidity of extensive myocardial revascularization, using arterial grafts in patients undergoing isolated coronary artery bypass grafting (CABG).
  
  
  
  Our prospective perioperative database was used to define two groups of patients who underwent isolated CABG with cardiopulmonary bypass, based on the years in which the operation was performed: Group A (2000-2003; 898 patients) and Group B (2009-2012; 1249 patients). The baseline and operative characteristics and outcomes were compared.
  
  
  
  Several significant changes in perioperative variables were observed. Group B included higher percentages of patients aged over 80 years (+58.1%), with diabetes (+32.0%) and with a history of percutaneous coronary intervention (+24.9%). The mean EuroSCORE II was significantly increased from 2.5 ± 4.4% in Group A to 3.2 ± 5.7% in Group B (P= 0.001). The mean number of distal anastomoses was significantly increased over time (total: 2.6 ± 0.8 vs 3.1 ± 1.0, P< 0.0001 and with arterial grafts: 1.6 ± 0.8 vs 2.6 ± 0.9, P< 0.0001). In-hospital mortality was low and did not significantly differ between Groups A and B (1.3 vs 2.4%; P= 0.08). Significant increases of new-onset atrial fibrillation (11.7 vs 21.9%, P= 0.017) and deep sternal infection (0.2 vs 1.1%, P= 0.017) were observed in Group B, compared with Group A. In multivariate analysis, extensive use of arterial grafts was not a risk factor of hospital mortality or sternal morbidity.
  
  
  
  Despite the increasing risk profiles of patients undergoing CABG, extensive myocardial revascularization using arterial grafts is associated with good early results.
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France michel.kindo@chru-strasbourg.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Kindo
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Tam
authors.initials: T
authors.lastname: Hoang Minh
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Perrier
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bentz
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Mommerot
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Billaud
authors.affiliation: Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Mazzucotelli
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Coronary artery bypass grafting, arterial grafts; Coronary artery bypass grafts; Coronary artery disease; Outcomes