Minimally Invasive Direct Coronary Artery Bypass Graft Surgery or Percutaneous Coronary Intervention for Proximal Left Anterior Descending Artery Stenosis:

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Minimally Invasive Direct Coronary Artery Bypass Graft Surgery or Percutaneous Coronary Intervention for Proximal Left Anterior Descending Artery Stenosis: A Meta- Analysis Salil V. Deo, MS, MCh, Vikas Sharma, MS, MCh, Ishan K. Shah, MBBS, Patricia J. Erwin, BLS, Lyle D. Joyce, MD, Soon J. Park, MD The Annals of Thoracic Surgery Volume 97, Issue 6, Pages 2056-2065 (June 2014) DOI: 10.1016/j.athoracsur.2014.01.086 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart demonstrating procedure of the systematic review process. (Reproduced from Moher et al [5].) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Forest plot pooling together the duration of hospital stay for both cohorts. The minimally invasive direct coronary artery bypass graft surgery (MIDCAB) group had a significantly longer stay compared with the percutaneous coronary intervention (PCI) cohort (p = 0.001). (CI = confidence interval; SMD = standardized mean difference.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The forest plot shows the pooled results of mortality between the two cohorts, and demonstrates that mortality in the two groups is comparable (A) during early follow-up and (B) at midterm follow-up. (CI = confidence interval; MIDCAB = minimally invasive direct coronary artery bypass graft surgery; PCI = percutaneous coronary intervention; RR = risk ratio.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Contour-enhanced funnel plot demonstrating absence of publication bias among included studies. (Dark gray area = 0.1 > p > 0.05; medium gray area = 0.05 > p > 0.01; light gray area = p > 0.01.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Forest plots demonstrating recurrence of angina in the (A) early period and (B) intermediate period. (CI = confidence interval; MIDCAB = minimally invasive direct coronary artery bypass graft surgery; PCI = percutaneous coronary intervention; RR = risk ratio.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Forest plot demonstrates the individual and pooled incidence of myocardial infarction in the minimally invasive direct coronary artery bypass graft surgery (MIDCABG) and percutaneous coronary intervention (PCI) cohorts. The incidence of acute myocardial infarction (AMI) was comparable at (A) early follow-up and (B) and midterm follow-up. (CI = confidence interval; RR = risk ratio.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Forest plot demonstrates the pooled need for reintervention in the (A) early period and (B) intermediate period. (CI = confidence interval; MIDCAB = minimally invasive direct coronary artery bypass graft surgery; PCI = percutaneous coronary intervention; RR = risk ratio.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 The forest plot presents the need for target vessel reintervention (TVR [midterm follow-up]) stratified by the type of drug-eluting stent (DES) used. As demonstrated by the lower part of the figure (DES = 1), the risk of reintervention was higher with DES when compared with minimally invasive direct coronary artery bypass graft surgery (MIDCABG). (CI = confidence interval; PCI = percutaneous coronary intervention; RR = risk ratio.) The Annals of Thoracic Surgery 2014 97, 2056-2065DOI: (10.1016/j.athoracsur.2014.01.086) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions