ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
This article is part of the Research TopicSurgical Revascularization of the Ischemic Myocardium in the third millenniumView all 6 articles
Coronary Artery Bypass Grafting in Patients with Hematological Neoplasms
Provisionally accepted
- Peking University People's Hospital, Beijing, China
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Background: Coronary artery bypass grafting (CABG) in patients with concurrent coronary artery disease (CAD) and hematological neoplasms presents unique challenges due to immunosuppression, hematologic dysfunction, and coagulopathy. This study aimed to assess the safety and feasibility of CABG in this population and to evaluate factors influencing prognosis. Methods: This retrospective study included 41 patients with CAD and hematological neoplasms who underwent CABG between 2018 and 2023. Hematological neoplasms were classified into seven categories, and patients were stratified by hematological disease status: stable, disease-free, or progressive. Key perioperative outcomes, graft patency, and survival data were analyzed. Cox regression models identified independent predictors of prognosis. Results: Of the 41 patients, 28 (68.3%) were stable, 10 (24.4%) were disease-free, and 3 (7.3%) were progressive. The median preoperative platelet count was 143×10⁹/L, with 8 patients presenting counts <50×10⁹/L requiring preoperative platelet transfusions. Postoperative transfusion rates for packed red blood cells (PRBCs), fresh frozen plasma (FFP) and platelets were 51.2%, 39.0%, and 12.2%, respectively. The median operation time was 210 minutes, with 87.8% undergoing off-pump CABG. Graft patency at discharge was 92.3%. Major infections occurred in 4.9% of patients, and 9 (22%) deaths were recorded during follow-up, 8 due to hematological progression and 1 due to myocardial infarction. Cox regression identified preoperative blood cell levels as independent predictors of survival (p < 0.05), while CABG-related factors showed no significant association. (p > 0.05). Conclusions: CABG is a viable option for carefully selectedcan be performed safely in most patients with stable hematological neoplasms, with no perioperative mortality, providing an opportunity for further hematological treatments. Preoperative blood cell levels significantly influence prognosis, underscoring the importance of multidisciplinary management. Larger studies are needed to validate these findings and refine treatment strategies.
Keywords: CABG, hematological neoplasms, multidisciplinary management, Coronary Artery Disease, preoperative blood cell level
Received: 02 Sep 2025; Accepted: 02 Dec 2025.
Copyright: © 2025 Zhang, Zhang, Jiang, Liu, Gao, Lian, Liu and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi Shi
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