Faisal G Bakaeen

Publications (70)247.14 Total impact

• Article: Performing Coronary Artery Bypass Grafting Off-Pump May Compromise Long-Term Survival in a Veteran Population.

  Faisal G Bakaeen, Danny Chu, Rosemary F Kelly, Herbert B Ward, Michael E Jessen, G John Chen, Nancy J Petersen, William L Holman
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  ABSTRACT: BACKGROUND: There are ample data regarding the short-term outcomes of on-pump and off-pump coronary artery bypass grafting (CABG), but little is known about the long-term survival associated with these approaches. METHODS: Using the Veterans Affairs (VA) Continuous Improvement in Cardiac Surgery Program, we identified all VA patients (n = 65,097) who underwent primary isolated CABG from October 1997 to April 2011. The primary outcome measure was all-cause mortality. Age, 17 preoperative risk factors, and year of operation were used to calculate propensity scores for each patient. A greedy-match algorithm using the propensity scores matched 8,911 off-pump with 26,733 on-pump patients. Survival functions were estimated by the Kaplan-Meier method and compared by using the log-rank test. RESULTS: In the complete cohort, off-pump was used in 11,629 of 65,097 (17.9%) operations. For the matched cohort, the median follow-up was 6.7 years (interquartile range, 3.72 to 9.35 years). Risk-adjusted mortality did not differ significantly between the off-pump and on-pump groups at 1 year (4.67% vs 4.78%; risk ratio [RR], 0.98; 95% confidence interval [CI], 0.88 to 1.09) or 3 years (9.21% vs 8.89%; RR, 1.04; 95% CI, 0.96 to 1.12). However, risk-adjusted mortality was higher in the off-pump group at 5 years (14.47% vs 13.45%; RR, 1.08; 95% CI 1.02 to 1.15) and 10 years (25.18% vs 23.57%; RR, 1.07; 95% CI, 1.03 to 1.12). Overall, the hazard ratio for off-pump vs on-pump was 1.06 (95% CI, 1.00 to 1.13; p = 0.04). CONCLUSIONS: Off-pump CABG may be associated with decreased long-term survival. Further studies are needed to identify the reasons behind this finding.
  The Annals of thoracic surgery 05/2013; · 3.74 Impact Factor
• Article: Double-staged approach for advanced mitral-tricuspid disease.

  Faisal G Bakaeen, Alvin Blaustein, Nadir Ali, Lorraine D Cornwell
  The Annals of thoracic surgery 05/2013; 95(5):1842. · 3.74 Impact Factor
• Article: Bioprosthetic mitral valve endocarditis after percutaneous device closure of severe paravalvular leak.

  Alexandra Tuluca, Raed Al-Najjar, Lorraine D Cornwell, Alvin Blaustein, Richard Hamill, Rabih O Darouiche, Faisal G Bakaeen
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  ABSTRACT: A large mitral paravalvular leak in a 63-year-old patient was closed by percutaneous placement of 2 Amplatzer Septal Occluder (AGA Medical Corporation, Plymouth, MN) devices. The patient had a residual paravalvular leak and subsequently developed infective endocarditis that was successfully treated by removal of all hardware and implantation of a new valve. Transcatheter treatment of paravalvular leaks may be useful in select patients who are poor candidates for open surgery; however, one must be aware of the potential complications. This report underscores the risk of device infection that may be increased if there is turbulence related to residual paravalvular leaks.
  The Annals of thoracic surgery 05/2013; 95(5):1787-9. · 3.74 Impact Factor
• Article: Deployment of proximal thoracic endograft in zone 0 of the ascending aorta: treatment options and early outcomes for aortic arch aneurysms in a high-risk population.

  Ourania Preventza, Faisal G Bakaeen, Roberto D Cervera, Joseph S Coselli
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  ABSTRACT: OBJECTIVES: Open repair of aortic arch aneurysms can be technically challenging. Hybrid approaches have been developed to facilitate arch repairs and improve their clinical outcomes in high-risk patients. We examined treatment options and early outcomes in patients whose thoracic endografts were deployed to include Zone 0. METHODS: Between 2005 and 2011, a hybrid approach in which the endograft was deployed in the ascending aorta was used in 29 patients (median age 67 years, range 32-85 years). The indication for surgery was saccular arch aneurysm in 11 patients (37.9%), fusiform arch aneurysm with or without involvement of the proximal descending aorta in 10 (34.5%), proximal Type I endoleak after endovascular repair of the descending aorta in 5 (17.2%), chronic Type III (Type B) aortic dissection with aneurysmal arch formation in 2 (6.9%) and acute Type I (Type A) dissection with prior repair of an extent I thoracoabdominal aneurysm in 1 (3.4%). Six patients (20.7%) had previously undergone a sternotomy. One-, two- or three-branch aortobrachiocephalic de-branching, with or without concomitant heart surgery, was performed in 28 patients and extra-anatomic bypass in 1. RESULTS: Two patients (6.9%) died during postoperative hospitalization. Overall survival during the follow-up period (median 411 days) was 79.3%. Five neurological events occurred: one extensive stroke, two minor strokes (10.3%) and two episodes of paraparesis (6.9%), one with partial recovery and one with full recovery. CONCLUSIONS: The hybrid approach enables the treatment of aortic arch disease in high-risk individuals. Long-term follow-up data are needed.
  European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 03/2013; · 2.40 Impact Factor
• Article: Transcatheter Aortic Valve Replacement as a Treatment for Late Apicoaortic Conduit Obstruction in a Patient With Severe Aortic Stenosis.

  Hani Jneid, Biswajit Kar, David Paniagua, Alvin Blaustein, Lorraine Cornwell, Glenn N Levine, Nadir Ali, Carlos F Bechara, Panos Kougias, Prasad V Atluri, Christopher Pawlak, Blasé Carabello, Biykem Bozkurt, Faisal G Bakaeen
  Circulation 03/2013; 127(11):e491-e494. · 14.74 Impact Factor
• Article: Innominate artery cannulation: An alternative to femoral or axillary cannulation for arterial inflow in proximal aortic surgery.

  Ourania Preventza, Faisal G Bakaeen, Elizabeth H Stephens, Susan M Trocciola, Kim I de la Cruz, Joseph S Coselli
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  ABSTRACT: OBJECTIVE: To evaluate the effectiveness of innominate artery cannulation in proximal aortic procedures, including those involving hypothermic circulatory arrest. METHODS: A total of 68 patients underwent innominate artery cannulation with a side graft during proximal aortic surgery performed by way of a median sternotomy. The indications for surgery were proximal arch aneurysm in 43 patients (63.2%), aortic dissection in 11 patients (16.2%), total arch aneurysm in 10 patients (14.7%), and ascending aortic aneurysm in 4 patients (5.9%). Six patients (8.8%) had undergone previous sternotomy. Hypothermic circulatory arrest with antegrade cerebral perfusion was used in 64 patients (94.1%). Of the 68 patients, 63 (92.6%) received antegrade cerebral perfusion to both cerebral hemispheres. The median antegrade cerebral perfusion time was 20 minutes (range, 15.0-33.0 minutes). Seven patients had periods of circulatory arrest without antegrade cerebral perfusion for a median of 20 minutes (range, 6-33 minutes). RESULTS: One patient died, for 30-day mortality of 1.5%. Three patients (4.4%) had strokes, two of whom had a partial recovery. Seven patients (10.3%) developed temporary postoperative confusion that resolved successfully in all cases. CONCLUSIONS: Cannulating the innominate artery for arterial inflow is an alternative technique for proximal aortic surgery procedures. It is especially useful in cases requiring hypothermic circulatory arrest to deliver antegrade cerebral perfusion.
  The Journal of thoracic and cardiovascular surgery 12/2012; · 3.41 Impact Factor
• Article: Video-assisted thoracoscopic lobectomy is associated with better perioperative outcomes than open lobectomy in a veteran population.

  Miguel D Cajipe, Danny Chu, Faisal G Bakaeen, Roberto F Casal, Scott A Lemaire, Joseph S Coselli, Lorraine D Cornwell
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  ABSTRACT: BACKGROUND: We sought to establish the feasibility and efficacy of video-assisted thoracoscopic (VATS) lobectomy in treating lung cancer in a veteran population. METHODS: We retrospectively analyzed preoperative, intraoperative, and postoperative parameters in 46 VATS versus 45 open lobectomy patients at a single center. RESULTS: The 2 groups were similar in preoperative and intraoperative variables. Although surgical mortality was not significantly different after lobectomy performed with VATS (0 of 46) compared with open lobectomy (2 of 45, 4%; P = .2), there were fewer complications in VATS patients (14 of 46, 30%) than their open counterparts (26 of 45, 58%; P = .009). VATS patients also had a shorter chest tube duration and length of stay. In multivariate analysis, VATS was associated independently with a reduced risk of complications (odds ratio, .359; P = .04). CONCLUSIONS: VATS lobectomy in a veteran population is feasible and safe and may lead to better perioperative outcomes than open thoracotomy without compromising oncologic principles.
  American journal of surgery 09/2012; · 2.36 Impact Factor
• Article: Nationwide trends and regional/hospital variations in open versus endovascular repair of thoracoabdominal aortic aneurysms.

  Joshua M Liao, Faisal G Bakaeen, Lorraine D Cornwell, Kiki Simpson, Scott A Lemaire, Joseph S Coselli, Danny Chu
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  ABSTRACT: Thoracic endovascular aortic repair (TEVAR) has been gaining popularity for the treatment of thoracoabdominal aortic aneurysm (TAAA). We used a nonvoluntary database to examine national trends and regional/hospital variations in the use of TEVAR and open thoracic aortic repair (OTAR) for TAAA. From the 2005-2008 Nationwide Inpatient Sample database, we identified all patients with the diagnosis of TAAA who were treated with TEVAR or OTAR. Rates of these procedures were compared between years, across geographic regions, and between hospitals of various bed sizes. Over the study period, the rate of OTAR remained relatively stable (range, 7.5/100 patients in 2005 to 10.1/100 patients in 2008; P = .26), whereas the rate of TEVAR increased dramatically (range, 1.4/100 patients in 2005 to 6.3/100 patients in 2008; P < .0001). In 2008, 29% (211) of all TEVAR procedures and 11% (130) of all OTAR procedures were performed in western regions of the United States (P = .03). Additionally, 13% (95) of all TEVAR procedures and 3% (35) of all OTAR procedures were performed in smaller hospitals (P < .0001). The use of TEVAR for TAAA repair increased significantly over the study period, whereas OTAR rates remained relatively stable. Our findings suggest that more patients who were otherwise not surgical candidates or did not have traditional surgical indications for OTAR were treated with TEVAR, most commonly in regions or hospitals where OTAR is less often performed. Given the complexity of TAAA cases, these results may have significant implications for patient safety in the current era of heightened health care scrutiny.
  The Journal of thoracic and cardiovascular surgery 09/2012; 144(3):612-6. · 3.41 Impact Factor
• Article: Establishment of a transcatheter aortic valve program and heart valve team at a Veterans Affairs facility.

  Faisal G Bakaeen, Biswajit Kar, Danny Chu, Lorraine D Cornwell, Alvin Blaustein, Glenn N Levine, David Paniagua, Hani Jneid, Corey Jensen, Prasad V Atluri, Carlos F Bechara, Panos Kougias, Chris Pawlak, Biykem Bozkurt, Thomas A Burdon, Blase A Carabello
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  ABSTRACT: BACKGROUND: The US Food and Drug Administration recently approved a transcatheter aortic valve for patients for whom open heart surgery is prohibitively risky. METHODS: A multidisciplinary heart valve team partnered with administration to launch a transcatheter aortic valve replacement (TAVR) program. Clinical registries were used to show robust valve caseloads and outcomes at our Veterans Affairs (VA) facility and to project future volumes. A TAVR business plan was approved by the VA leadership as part of a multiphase project to upgrade and expand our surgical facilities. RESULTS: The heart valve team completed a training program that included simulations and visits to established TAVR centers. Patients were evaluated and screened through a streamlined process, and the program was initiated successfully. CONCLUSIONS: Establishing a TAVR program at a VA facility requires a multidisciplinary team with experience in heart valve and endovascular therapies and a supportive administration willing to invest in a sophisticated infrastructure.
  American journal of surgery 08/2012; · 2.36 Impact Factor
• Article: Coronary artery bypass graft patency: residents versus attending surgeons.

  Faisal G Bakaeen, Gulshan Sethi, Todd H Wagner, Rosemary Kelly, Kelvin Lee, Anjali Upadhyay, Hoang Thai, Elizabeth Juneman, Steven Goldman, William L Holman
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  ABSTRACT: Data are limited regarding the patency of coronary artery bypass grafts performed by residents versus attending surgeons. We analyzed data from a multicenter, randomized Veterans Affairs Cooperative Study in which the left internal mammary artery was used preferentially to graft the left anterior descending coronary artery, and the best remaining coronary vessel received (per random assignment) either a radial artery or a saphenous vein graft. The study vessel's 1-year graft patency was the primary outcome measure. Secondary outcomes included operative times, operative morbidity, mortality, repeat revascularization, cost, angina symptoms, and quality of life. Multivariate analyses were used to compare patient outcomes for residents versus attendings. Residents were designated as primary surgeons in 23% of cases (167 of 725). Among the 531 patients who had a 1-year angiogram, study graft patency rates for resident cases (n=122) and attending cases (n=409) were not significantly different (86% versus 90%, p=0.22). Residents' cases had longer perfusion time (119 versus 105 minutes, p<0.0001) and cross-clamp time (84 versus 68 minutes, p<0.0001). After risk adjustment, all outcome measures did not differ between the two groups, and there was no apparent interaction effect between resident/attending designation and radial artery versus saphenous vein use or on-pump versus off-pump approach. Surgeons in training perform coronary artery bypass surgery without compromising graft patency or patient outcomes. Ongoing evaluation of residents' performance and surgical outcomes is needed, given the major changes that are occurring in residency training.
  The Annals of thoracic surgery 06/2012; 94(2):482-8; discussion 488. · 3.74 Impact Factor
• Article: The natural history of moderate aortic stenosis in a veteran population.

  Poornima Yechoor, Alvin S Blaustein, Faisal G Bakaeen, Lorraine D Cornwell, Joseph S Coselli, Scott A Lemaire, Danny Chu
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  ABSTRACT: OBJECTIVE: Our objective was to evaluate the natural history of moderate aortic stenosis in veterans-a unique patient population with significant comorbidities. METHODS: We retrospectively reviewed the records of all patients who underwent echocardiography at a single veterans affairs hospital during 2006. We identified consecutive patients who had moderate aortic stenosis as indicated by a mean transaortic gradient of 25 to 40 mm Hg, peak aortic jet velocity of 3 to 4 m/s, or aortic valve area of 1.0 to 1.5 cm(2). The primary end point was defined as survival without aortic valve replacement. RESULTS: Of the 104 patients (mean age, 74 ± 10 years), 49% had diabetes, 21% had peripheral vascular disease, 21% were current smokers, 18% had chronic obstructive pulmonary disease, 60% had coronary artery disease, 89% had hypertension, and 31% had a body mass index of 30 kg/m(2) or more. Mean ejection fraction was 49% ± 12%. During the mean follow-up period of 22 months (range, 1-67 months), 30% of patients underwent aortic valve replacement-26% for symptomatic severe aortic stenosis and 4% concomitantly with coronary artery bypass grafting as the primary indicated operation-and 61% died. Event-free survivals were 48%, 24%, and 15% at 1, 3, and 5 years, respectively. CONCLUSIONS: Our cohort of military veteran patients had significant comorbidities. Event-free survival for such patients who have moderate aortic stenosis is significantly lower than previously reported data suggest. Within this unique group of patients, identifying factors that accelerate the progression of moderate aortic stenosis would help surgeons select patients who may benefit from early aortic valve replacement for moderate aortic stenosis.
  The Journal of thoracic and cardiovascular surgery 06/2012; · 3.41 Impact Factor
• Article: Morbid obesity is associated with increased resource utilization in coronary artery bypass grafting.

  Justin C Choi, Faisal G Bakaeen, Lorraine D Cornwell, Tam K Dao, Joseph S Coselli, Scott A LeMaire, Danny Chu
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  ABSTRACT: Studies have shown good outcomes for morbidly obese patients who undergo cardiac surgery. However, little is known about how much additional resource utilization treating these challenging patients requires. We hypothesized that morbidly obese patients (body mass index ≥40 kg/m(2)) undergoing coronary artery bypass grafting needed longer operating room times and had longer hospital and intensive care unit stays than non-morbidly obese patients. We reviewed data from all morbidly obese patients (n = 56, body mass index = 42.7 ± 2.6 kg/m(2)) who underwent coronary artery bypass grafting at our institution between 1999 and 2009. These patients' outcomes were compared with those of non-morbidly obese patients (n = 168, body mass index = 30.0 ± 2.8 kg/m(2)) who were propensity-matched 3:1 with the morbidly obese patients. Of the 14 preoperative characteristics examined, only 1, creatinine level, differed significantly between the two groups (p = 0.02). Intraoperative and postoperative complication rates and the mortality rate were similar between groups (p > 0.09). However, morbidly obese patients had longer operating times (449 ± 70 versus 420 ± 59 minutes; p = 0.002), intensive care unit stays (5.2 versus 3.3 days; p < 0.005), and postoperative hospital stays (14.2 versus 9.5 days; p < 0.005) than the non-morbidly obese patients. Although good outcomes can be achieved for morbidly obese patients who undergo coronary artery bypass grafting, these patients require considerably more resource utilization in the operating room and intensive care unit, and they spend more time in the hospital after surgery. At a cardiac surgical operating room cost of approximately $50 per minute and $4,500 per intensive care unit day, the financial implications for morbidly obese patients who need coronary artery bypass grafting are not insignificant.
  The Annals of thoracic surgery 05/2012; 94(1):23-8; discussion 28. · 3.74 Impact Factor
• Article: Impact of functional status on survival after coronary artery bypass grafting in a veteran population.

  Roberto Cervera, Faisal G Bakaeen, Lorraine D Cornwell, Xing Li Wang, Joseph S Coselli, Scott A LeMaire, Danny Chu
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  ABSTRACT: Although functional impairment has been shown to be an adverse outcome of frailty, little is known of its effect on patients after cardiac operations. We aimed to assess the effect of limited functional status on long-term survival after coronary artery bypass grafting (CABG). We reviewed prospectively gathered data from 1,503 consecutive patients who underwent isolated CABG between 1997 and 2009. We compared the outcomes of 318 patients with limited functional status and 1,185 patients without any functional impairment. The mean follow-up period was 65 months (range, 1 to 157 months). We assessed the relationship between functional status impairment and long-term survival by Cox regression analysis adjusted for confounding factors. Functionally impaired patients were slightly older (63±9 vs 62±8 years, p=0.05) and had more risk factors for adverse outcomes than patients who were functionally unimpaired. After adjustment for potential confounding variables by multivariate logistic regression analysis, preoperative limited functional status was not an independent predictor (odds ratio [95% confidence interval]) of 30-day mortality (1.4 [0.3 to 5.8], p=0.67) or major adverse cardiac events (1.3 [0.5 to 3.3], p=0.71), nor was it predictive of reduced long-term survival (10-year hazard ratio 1.0 [0.7 to 1.4], p=0.85). Limited functional status was not an independent risk factor for early postoperative complications or death. Long-term survival in patients whose functional status was impaired before they underwent CABG was similar to that of patients who were functionally independent.
  The Annals of thoracic surgery 05/2012; 93(6):1950-4; discussion 1954-5. · 3.74 Impact Factor
• Article: Perceptions and expectations of cardiothoracic residents and attending surgeons.

  Elizabeth H Stephens, Lorraine D Cornwell, Katherine H Simpson, Danny Chu, Joseph S Coselli, William L Holman, Ara A Vaporciyan, Walter H Merrill, Faisal G Bakaeen
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  ABSTRACT: With our specialty going through a critical phase of re-evaluation and adaptation, our aim was to evaluate and compare the perceptions and expectations among residents and faculty regarding cardiothoracic training. A content-validated, 13-item survey was distributed electronically from August 14 to August 24, 2010 to 728 cardiothoracic surgery residents, recent program graduates (on or after June 2006), cardiothoracic surgery chairpersons, and program directors identified in the Cardiothoracic Surgery Network database. The response rate was 34% (244 of 728). Of the respondents, 76% reported being "satisfied" or "very satisfied" with their program. Faculty willingness to teach in the operating room was ranked as the most valuable aspect of a training program, and strict adherence to the 80-h work week ranked as least valuable. Most respondents believed that a resident performing at least 75% of a case was acceptable for low-complexity procedures (92% of residents, 77% of attending physicians) and at least 25% for high-complexity procedures (91% of residents, 73% of attending physicians). However, residents wanted to perform more of the operations than the attending physicians considered necessary (P < 0.05). Finally, 63% of respondents (73% of residents, 56% of attending physicians) indicated that the increasing scrutiny of outcomes has adversely affected training. Other differences between the residents' and attending physicians' perceptions regarded the importance of participation in preoperative and postoperative care, what constitutes "scut work," and the value of auxiliary staff. Reconciling residents' expectations with the realities of duty-hour restrictions and high-stakes procedures will require the development of novel educational approaches to improve resident learning.
  Journal of Surgical Research 04/2012; 177(2):e45-52. · 2.25 Impact Factor
• Article: Clinical outcome of staged versus combined treatment approach of hybrid repair of thoracoabdominal aortic aneurysm with visceral vessel debranching and aortic endograft exclusion.

  Peter H Lin, Panagiotis Kougias, Carlos F Bechara, Sarah M Weakley, Faisal G Bakaeen, Scott A Lemaire, Joseph S Coselli
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  ABSTRACT: Although visceral vessel debranching and endovascular aneurysm exclusion represents a hybrid treatment approach in patients with thoracoabdominal aortic aneurysm, the effect of timing with regard to the visceral debranching procedure and endovascular aneurysm exclusion in this treatment strategy remains unclear. In this study, the authors analyzed their recent institutional experience of visceral debranching and aneurysm stent-grafting procedures. Specifically, the authors compared the effect of staged (n = 27) versus combined (n = 31) hybrid treatment in patients with complex aortic aneurysms. This study showed a higher incidence of renal insufficiency in patients undergoing a combined hybrid repair than the staged hybrid approach. The possibility of aneurysm rupture may exist in the staged treatment approach if the duration of staged repair is prolonged. The combined hybrid treatment strategy should be performed with caution as it is associated with significantly higher complication rates than the staged hybrid treatment modality.
  Perspectives in Vascular Surgery 02/2012; 24(1):5-13.
• Article: Reply.

  Danny Chu, Faisal G Bakaeen
  The Annals of thoracic surgery 12/2011; 92(6):2305-6. · 3.74 Impact Factor
• Article: Predicting mortality in high-risk coronary artery bypass: surgeon versus risk model.

  Lorraine D Cornwell, Danny Chu, Timothy Misselbeck, Scott A LeMaire, Joseph Huh, Shubhada Sansgiry, Joseph S Coselli, Faisal G Bakaeen
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  ABSTRACT: Risk models are useful in evaluating and comparing surgical outcomes, but surgeons may not always agree with the risk estimates derived from these models, particularly in high-risk cases. We examined the concordance between surgeons' and a risk model's predictions of operative mortality in high-risk coronary artery bypass grafting (CABG) patients, and we attempted to identify the reasons for any discrepancies. From the Veterans Affairs Continuous Improvement in Cardiac Surgery Program (CICSP), a prospective database and cardiac surgery risk model, we obtained data regarding 181 high-risk, isolated CABG cases performed at a single institution between April 1998 and April 2008. Cases were considered high risk if the surgeon estimated the patient's operative mortality risk to be ≥ 10%. We compared the mortality predictions made by surgeons and the risk model by using the signed-rank test and investigated cases in which there was a significant discrepancy (at least 2-fold) between the two predictions. The observed 30-d/in-hospital and 180-d mortality rates were 6.1% (11/181) and 11.0% (20/181), respectively. The mean operative mortality prediction made by surgeons (12.0% ± 5.3%) was higher than that made by the risk model (7.5% ± 8.5%) (P < 0.001). There was significant discrepancy between the surgeon and risk model estimates in 62% (113/181) of cases. In 53% (60/113) of these cases, the surgeon reported having considered risk factors not included in the CICSP model, including (most commonly) possible need for an additional procedure (n = 15), compromised mobility (n = 11), liver disease (n = 9), hematologic or immunologic disease (n = 6), and quality of targets (n = 5). In high-risk CABG cases, surgeon and CICSP risk estimates often disagreed markedly, partly because some disease entities of concern to surgeons are not included in the risk model. The higher mortality risk estimated by the surgeons is a better reflection of the considerable mortality risk that extends up to 180 days after surgery.
  Journal of Surgical Research 10/2011; 174(2):185-91. · 2.25 Impact Factor
• Article: The obesity paradox and cardiac surgery: are we sending the wrong message?

  Faisal G Bakaeen, Danny Chu
  The Annals of thoracic surgery 09/2011; 92(3):1153; author reply 1153-4. · 3.74 Impact Factor
• Article: Costs and quality of life associated with radial artery and saphenous vein cardiac bypass surgery: results from a Veterans Affairs multisite trial.

  Todd H Wagner, Gulshan Sethi, William Holman, Kelvin Lee, Faisal G Bakaeen, Anjali Upadhyay, Edward McFalls, H Gareth Tobler, Rosemary F Kelly, Michael D Crittenden, Hoang Thai, Steven Goldman
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  ABSTRACT: In coronary artery bypass grafting (CABG) surgery, there is uncertainty about whether the radial artery affects quality of life or costs relative to the saphenous vein. This study compared the cost and quality of life for patients randomized to either radial artery or saphenous vein grafts. We analyzed the duration and cost of the index surgery and costs and quality of life (Seattle Angina Questionnaire and Health Utility Index) at 1 year for 726 participants. The 2 treatment groups had similar baseline characteristics. Using the radial artery added approximately 31 minutes to the surgery (from skin incision to skin closure; P < .001) compared with a saphenous vein graft. There were no significant differences in terms of costs and quality of life after the index hospitalization or at 1 year. Coronary artery bypass grafting with the radial artery lasts approximately 31 minutes longer than with the saphenous vein. However, costs and the quality of life were not statistically different.
  American journal of surgery 08/2011; 202(5):532-5. · 2.36 Impact Factor
• Article: Aspirin plus clopidogrel versus aspirin alone after coronary artery bypass grafting.

  Faisal G Bakaeen, Danny Chu
  Journal of the American College of Cardiology 08/2011; 58(6):657; author reply 657. · 14.16 Impact Factor