Coronary artery bypass grafting: Factors affecting outcomes

Introduction: Coronary artery bypass grafting forms the bulk of a cardiac surgeon's workload. An extensive amount of research has been undertaken to improve the outcomes of this procedure. This literature review aimed to summarize key areas that influence coronary artery bypass grafting in modern day practice.

Methods: A comprehensive electronic search was done using PubMed, Ovid, SCOPUS, Embase and google scholar from inception to July 2020. Articles were included if they discussed factors affecting outcomes in coronary bypass grafting (CABG). Case reports, expert opinion, and editorials were excluded.

Results: There are many factors that influence and predict outcomes following coronary artery bypass surgery. Age, diabetes, and isolated systolic hypertension were preoperative factors with strong correlation to mortality and morbidity rates post CABG. In addition to these, the degree of renal failure and heart failure correlated with poorer operative results. The use of the left internal mammary artery has transformed outcomes and has proven advantage over venous conduit use. Newer minimal invasive techniques have the potential to further optimize outcomes.

Conclusion: The numerous and complex factors which impair outcomes following CABG need to be further researched and addressed using larger trials and possible optimization of multi-disciplinary team approach to further improve long term outcomes.