Off-pump coronary artery bypass grafting in high-risk patients / 中国微创外科杂志

5) receiving cardiopulmonary coronary artery bypass grafting(CCAB) during the same period was reviewed as control group(CCAB Group).The preoperative risk factors,operation parameters,and postoperative outcomes between the two groups were compared for statistical analysis.Results The EuroSCORE value of the OPCAB Group and the CCAB Group was 9.0?2.6 and 8.3?2.1,respectively(t=2.016,P=0.045). The number of grafts in the OPCAB Group was less than that in the CCAB Group(3.2?0.9 vs 3.8?0.9;t=-4.267,P=0.000).The postoperative levels of creatine kinase(CK) and creatine kinase myocardial band(CK-MB) were significantly lower in the OPCAB Group [570(61～8246) U/L and 20(1～282) U/L] than the CCAB Group [870(246～8155) U/L and 55(12～300) U/L](Z=-3.648 and-5.767,P=0.000).The blood transfusion in the OPCAB Group was significantly less than that in the CCAB Group(775?693 ml vs 1088?712 ml;t=-2.887,P=0.004).There was no statistical difference in postoperative complications between the two groups.The mortality is 3.5%(4/113) in the OPCAB Group and 6.6%(5/76) in the CCAB Group,without statistical difference(?2=0.925,P=0.336).Conclusions OPCAB is safe and effective in high risk patients.Different operation methods should be used for patients with different risks.

Appropriate timing of coronary artery bypass grafting surgery after acute myocardial infarction / 中华胸心血管外科杂志

Objective To evaluate the appropriate timing of coronary artery bypass grafting(CABG) with acute myocardial in- farction(AMI) and to discuss the influence of postoperative mortality on 30 days.Methods 233 patients after CABG were divided into 2 groups,AM/group and unstable angina (UA) group.There were 176 males (75.4%) and 57 females (24.5%).The mean age was (65.6?9.2) years(range 34～86 years).The mean grafts were 3.46?0.89.The complex risk elements between the 2 groups were analyzed to evaluate the independent risk element of death.Results Internal mammary arteries were used in 137 patients (58.8%).The postoperative mortality rate was 4.3 % (10/233).The operative mortality rates(OMR) were closely related to the in- creasing time intervals between AMI and CABG,for less than 3 days was 14.6% (6/41 cases),for 4 to 10 days was 2.7 % (1/37) and for 11 to 30 days was 0.The OMR of AMI less than 3 days has significant difference (P=0.033) comparing with that of unstable an- gina pectoris [2.3% (3/130) ].Conclusion Proper timing of CABG should be done in 3 days after AMI.