Beating heart coronary artery bypass: 100 case
Keywords:
Coronary artery bypass grafting - beating heart - ventricular dysfunctionAbstract
Background: Coronary artery revascularization with cardiopulmonary bypass has been reported to carry several risks.Aim: Off-pump coronary artery bypass grafting has been proposed to result in a better outcome. The aim of this study is to assess the effect of off-pump cardiopulmonary bypass.
Methods: In a 7-year period, a total of 100 patients undergoing isolated first-time off-pump coronary artery bypass graft were studied. The mean ejection fractions was 48% and the EUROSCORE mean was 4.9.
Results: The average number of grafts was 1.55 per patient. The postoperative outcomes were simple for most patients with little use of inotropes after 24 hours (42%), few cases of atrial fibrillation (9.4%), and transfusion (27.3%). Time to extubation was less than 48 hours in most cases (94.7%) and hospital mortality rate was 10.5%.
Conclusion : The beating heart bypass surgery allows good immediate results including multi-vessel disease and in patients at high risk.
Downloads
References
Roach GW, Kanchuger M, Mangant CM et al. Adverse cerebral outcoms after coronary bypass surgery. N Engl J Med 1996; 335:1857-63.
Magee MJ, Jablonski KA, Stamou SC, et al. Elimination off cardiopulmonary bypass improves early survival for multi vessel coronary artery bypass patients. Ann Thorac Surg 2002; 73:1196- 1203.
Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and mid term outcome after of pump and on pump surgery in Beating heart against cardioplegic arrest studies: a posoled analysis of two randomized controlled trials. Lancet 2002; 359(9313):1194-9.
Arom KV, Emery RW, Flavin TF, Kshettry VR, Petersen RJ. OPCAB surgery a critical review of two different catergories of preoperative ejection fraction. Eur J Cardiothoracic Surg 2001; 20:533-7.
Varghese D, Yacoub MH, Trimlett R, Amrani M. Outcome of non elective coronary bu pass grafting without cardiopulmonary bypass. Eur J cardiothoracic surg 2001; 19:245-8.
Kshettry VR, Flavin TF, Emery RW, Nicoloff DM, Arom KV, Petersen RJ. Does multivessel of pump coronary bypass reduce post operative morbidity? Ann Thorac Surg 2000; 69:1725-30.
Calafiore AM, Teodori G, Di Giammarco G, et al. Multiple arterial conduits without cardiopulmonary bypass: early angiographic results. Ann Thorac Surg 1999; 67:450-6.
Bergsland J, Hasnain S, Lajos TZ, Salerno TA. Elimination of cardiopulmonary bypass: a prime goal in reoperative coronary surgery. Eur, J Cardiothoracic Surg 1998; 14:59-62.
J Bergsland, S Schmid, J Yanulevich, S Hasnain, T Z Lajos, T A Salerno. Coronary artery bypass grafting without cardiopulmonary bypass: An attractive in high risk patients. Eur J Cardiothoracic Surg 1991; 11: 876-80.
Alwan K, Falcoz PE, Alwan J, et al. Beating versus arrested heart coronary revascularization: evaluation by cardiac troponin I release. Ann Thorac Surg 2004; 77: 2051-5.
Siebert J, Rogowski J, Jagielak D, Anisimowicz L, Lango R, Narkiewicz M. Atrial fibrillation after coronary bypass graftin without cardiopulmonary bypass. Eur J Cardiothorac Surg. 2000;17: 520-3.
Ricci M, Karamanoukian HL, Abraham R, et al. Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass. Ann Thorac Surg 2000; 69: 1471-5.
Sharony R, Bizekis CS, Kanchuger M, et al. Off pump coronary artery bypass grafting reduses moratlity and stokes in patients with atheromatous aortas. Circulation 2003; 108 Suppl 1:II15-20.
Zamvar V, Williams D, Hall J, et al. Assessment of neurocognitive impairment after of pump and on pump technics for coronary artery bypass graft surgery. BMJ 2002; 325(7375):1268.
Ascione R, Lloyd CT, Underwood MJ, Lotto AA, Pitsis AA, Angelini GD. Inflammatory, reprise after coronary revascularization with or without cardiopulmonary bypass. Ann Thorac Surg 2000; 69:1198-204.
Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothoracic Surg 2002; 21: 232-44.
Lund O, Christensen J, Holme S, et al. On pump versus off pump coronary artery bypass: independent risk factors and of pump graft patency. Eur J Cardiothoracic Surg 2001; 20: 901-7.
Calafiore AM, Di Mauro M, Canosa C, Di Giammarco G, Iacò AL, Contini M. Myocardial revascularization with and without cardiopulmonary bypass: advantages, disadvantage and similarities. Eur J Cardiothoracic Surg 2003; 24: 953-60.
Kim KB, Lim C, Lee C, et al. Off pump coronary by pass may decrease the patency of saphenous vein graft. Ann Thorac Surg 2001; 72: S1033-7.
