Application of multidisciplinary collaborative anticoagulation management after simultaneous coronary endarterectomy during coronary artery bypass grafting
Ou Shuizhen
Cheng Yunqing
Zhen Jianfan
Sun Tucheng
Yang Yuanyuan
Abstract：Objective To summarize the experience of multidisciplinary collaborative anticoagulation management for patients undergoing simultaneous coronary endarterectomy(CE)during coronary artery bypass grafting(CABG),so as to provide reference for clinical medical staff.Methods A total of 90 patients receiving combined CABG and CE in Guangdong Provincial People's Hospital from September 2017 to June 2024 were retrospectively enrolled.The patients were divided into multidisciplinary collaborative anticoagulation group(45 cases)and routine anticoagulation group(45 cases)according to postoperative anticoagulation regimens.Postoperative total incidence of bleeding events and early graft patency rate were compared between the two groups.Results Among the 90 surgical patients,7 cases required postoperative intra-aortic balloon pump support.The intensive care unit stay was 97.0(59.7,163.0)h,and the mechanical ventilation duration was 20.0(17.0,48.2)h.Perioperative myocardial infarction occurred in 3 patients,gastrointestinal bleeding in 1 patient,other bleeding events in 5 patients,and cerebrovascular accidents in 5 patients.The average hospital stay was(27±11)d.Three patients and their families chose self-discharge after surgery,1 patient died during follow-up,and 1 patient received secondary coronary stent implantation for restenosis of a target vessel at non-endarterectomy site at the second month after operation.The proportions of patients with New York Heart Association cardiac function class 3-4 before and after surgery were 67.8％(61/90)and 16.7％(15/90),respectively.The 24 h postoperative drainage volume,total incidence of bleeding events and postoperative blood transfusion rate in the multidisciplinary collaborative anticoagulation group were lower than those in the routine anticoagulation group[(347±52)ml vs(451±61)ml,0(0/45)vs 13.3％(6/45),4.4％(2/45)vs 17.8％(8/45)],while the early graft patency rate was higher[95.6％(43/45)vs 82.2％(37/45)](all P＜0.05).There were no statistically significant differences in the incidence of graft occlusion and graft stenosis ≥50％between the two groups(both P＞0.05).Conclusion Multidisciplinary collaborative anticoagulation management after combined CABG and CE can signifi-cantly reduce bleeding risk and improve early graft patency rate.
Keywords：Coronary endarterectomyCoronary artery bypass graftingMultidisciplinary team collabo-rationAnticoagulation management
Publication Date：2026-07-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 967-971 )