Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry

• Autor(a) principal: Paez,Rodrigo Pereira
• Data de Publicação: 2019
• Outros Autores: Hossne Junior,Nelson Américo, Santo,José Amalth do Espírito, Berwanger,Otavio, Santos,Renato Hideo Nakagawa, Kalil,Renato Abdala Karam, Jatene,Fabio B., Cavalcanti,Alexandre Biasi, Zilli,Alexandre Cabral, Bettiati Jr,Luiz Carlos, Figueira,Fernando Augusto Marinho dos Santos, D'Azevedo,Stephanie Steremberg Pires, Soares,Marcelo José Ferreira, Fernandes,Marcio Pimentel, Ardito,Roberto Vito, Bogdan,Renata Andrea Barberio, Campagnucci,Valquíria Pelisser, Nakasako,Diana, Rodrigues,Clarissa Garcia, Rodrigues Junior,Anilton Bezerra, Cascudo,Marcelo Matos, Atik,Fernando Antibas, Lima,Elson Borges, Nina,Vinicius José da Silva, Heluy,Renato Albuquerque, Azeredo,Lisandro Gonçalves, Henrique Junior,Odilon Silva, Mendonça,José Teles de, Silva,Katharina Kelly de Oliveira Gama, Pandolfo,Marcelo, Lima Júnior,José Dantas de, Faria,Renato Max, Santos,Jonas Gonçalves dos, Coelho,Guilherme Henrique Biachi, Pereira,Sergio Nunes, Senger,Roberta, Buffolo,Enio, Caputi,Guido Marco, Oliveira,Juliana Aparecida Borges de, Gomes,Walter J.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382019000200142
• topic: Registries; Database, Cardiovascular Surgical Procedures; Cardiac Surgical Procedures; Coronary Artery Bypass Grafts; Myocardial Revascularization

Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.