Coronary Disease - Surgery

Borracci and colleagues evaluated the incidence of acute kidney injury (AKI) in 418 patients during in-hospital care after cardiac surgery. The authors found AKI in 17.5 % of patients when considering the worst kidney function measurement in the postoperative period compared to 4.5 % of patients when only considering kidney function at discharge.

Takagi and colleagues performed a meta-analysis of eight randomized controlled trials comparing on-pump and off-pump coronary artery bypass grafting (CABG). They evaluated only trials with follow-up periods of five years or longer, and they pooled hazard ratios rather than odds ratios, where possible.

Once again, analyses of studies that are ostensibly well-designed randomized controlled trials have limitations that do not answer the question at hand: are two-arterial CABGs better than one? This editorial comments on a publication regarding the EXCEL Study, which showed no differences at 3 years.

An interesting randomized controlled trial asserting robustly that endoscopic harvesting of saphenous vein is: (1) better for leg dehiscence and (2) at least noninferior for MACE compared to the conventional open "full touch" method.