Mortality in myocardial revascularization surgery: an overview of systematic reviews
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i3e-243325Keywords:
Myocardial Revascularization, mortality, Treatment OutcomeAbstract
The analysis of mortality rates associated with coronary artery bypass grafting (CABG), with or without cardiopulmonary bypass, is relevant, as is its comparison with other therapeutic approaches for severe coronary artery disease, such as percutaneous coronary intervention (PCI), hybrid coronary revascularization (HCR), and medical therapy. This study is an overview of systematic reviews, based on the selection of full-text, open-access articles from three databases (LILACS, PubMed, and Cochrane Library), published between October 2013 and October 2023, in English, Portuguese, and Spanish. Of the 117 reviews identified, 10 were included in the final analysis. CABG showed lower mortality compared with PCI, especially in diabetic patients. The comparison between on-pump and off-pump CABG showed a 72% reduction in 30-day postoperative mortality in the off-pump group among patients at high risk for acute myocardial infarction. No statistically significant differences were found between mortality rates in CABG and HCR. The combination of CABG with medical therapy reduced mortality from cardiac causes, although it did not demonstrate a significant difference in all-cause mortality. Bilateral internal thoracic artery grafting was associated with lower long-term mortality. Complete arterial revascularization showed a lower risk of mortality compared with incomplete revascularization. The compiled results indicate that CABG appears to be the best option for certain outcomes and clinical situations. However, the choice among different approaches and surgical techniques should be individualized, with careful evaluation of the cost-benefit-risk balance in each clinical context.
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Copyright (c) 2026 Letícia Martins Cavalcanti, Luana Gomes Ribeiro, Rafaella Montagnier Eskenazi de Lima, Yanne Luisa Leite Barros, Gabriela de Andrade Lima Molina, Aurélio Molina da Costa
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