{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:20:05Z","timestamp":1787764805602,"version":"build-2784847793"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Coronary endarterectomy (CE) extends complete revascularisation to patients with diffuse coronary disease unsuitable for conventional bypass but adds perioperative risk to coronary artery bypass grafting (CABG). Whether the number of vessels endarterectomised influences early outcomes has not been formally synthesised. We compared short-term outcomes of single-vessel and multivessel CE-CABG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, Embase, and CENTRAL were searched for studies of CE-CABG reporting outcomes stratified by single-vessel versus multivessel CE within the same cohort. The primary outcome was 30-day or in-hospital mortality. Risk ratios (RR) were pooled using DerSimonian-Laird random-effects models. Sensitivity analyses included leave-one-out analysis, Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, and univariate meta-regression on study-level covariates. Risk of bias was assessed with ROBINS-I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine studies (1988-2022; 7,302 patients; 4,731 single-vessel CE, 2,571 multivessel CE) met inclusion criteria. Multivessel CE was associated with higher mortality (RR, 2.59; 95% CI, 1.78-3.77), higher perioperative myocardial infarction (RR, 2.09; 95% CI, 1.67-2.62), and higher stroke (RR, 1.62; 95% CI, 1.01-2.61). Intra-aortic balloon pump use did not differ. Findings were stable on leave-one-out, HKSJ adjustment, and exclusion of pre-2000 studies. No single covariate accounted for the multivessel effect on meta-regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multivessel CE substantially increases early mortality and infarction relative to single-vessel CE. The signal is consistent across analyses but the evidence is largely retrospective and unadjusted. These data support a selective approach to CE in which the prognostic value of each target vessel is weighed against the cumulative operative cost, rather than routine extension of endarterectomy to multiple territories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag238","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:39:15Z","timestamp":1787657955000},"source":"Crossref","is-referenced-by-count":0,"title":["Multivessel versus single-vessel coronary endarterectomy as an adjunct to coronary artery bypass grafting: A meta-analysis of short-term outcomes and implications for target-vessel selection"],"prefix":"10.1093","author":[{"given":"Joshua J","family":"Hon","sequence":"first","affiliation":[{"name":"Imperial College London Department of Surgery and Cancer, , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arian","family":"Arjomandi Rad","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust Department of Cardiothoracic Surgery, , Oxford,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Tahir","sequence":"additional","affiliation":[{"name":"University Hospitals of North Midlands Department of Trauma and Orthopaedics, , Stoke-on-Trent,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Salagean","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust Department of Cardiothoracic Surgery, , Oxford,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Moscarelli","sequence":"additional","affiliation":[{"name":"Imperial College London Department of Surgery and Cancer, , London,","place":["UK"]},{"name":"GVM Care&Research Department of Cardiovascular Surgery, Maria Eleonora Hospital, , Palermo,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios E","family":"Magouliotis","sequence":"additional","affiliation":[{"name":"Main Line Health Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, , Wynnewood, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Casula","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital Imperial College Healthcare NHS Trust Department of Cardiothoracic Surgery, , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Imperial College London Department of Surgery and Cancer, , London,","place":["UK"]},{"name":"Hammersmith Hospital Imperial College Healthcare NHS Trust Department of Cardiothoracic Surgery, , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,26]]},"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag238\/70806548\/ivag238.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag238\/70806548\/ivag238.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:42:42Z","timestamp":1787762562000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article\/doi\/10.1093\/icvts\/ivag238\/8771247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag238","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"article-number":"ivag238"}}