Risk Factors of On-Pump Conversion during Off-Pump Coronary Artery Bypass Graft
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 355-362, 2017.
Article
in English
| WPRIM
| ID: wpr-10927
ABSTRACT
BACKGROUND:
Off-pump coronary artery bypass grafting (OPCABG) procedures can avoid the complications of an on-pump bypass. However, some cases unexpectedly require conversion to cardiopulmonary bypass during OPCABG. The risk factors associated with a sudden need for cardiopulmonary bypass were analyzed.METHODS:
This retrospective study included 283 subjects scheduled for OPCABG from 2001 to 2010. These were divided into an OPCABG group and an on-pump conversion group. Preoperative, operative, and postoperative variables were compared between the 2 groups.RESULTS:
Of the 283 patients scheduled for OPCABG, 47 (16%) were switched to on-pump coronary artery bypass grafting (CABG). The mortality of the both the OPCABG and on-pump conversion groups was not significantly different. The major risk factors for conversion to on-pump CABG were congestive heart failure (CHF) (odds ratio [OR], 3.5; p=0.029), ejection fraction (EF) <35% (OR, 4.4; p=0.012), and preoperative beta-blocker (BB) administration (OR, 0.3; p=0.007). The use of intraoperative (p=0.007) and postoperative (p=0.021) inotropics was significantly higher in the conversion group. The amount of postoperative drainage (p<0.001) and transfusion (p<0.001) also was significantly higher in the conversion group. There were no significant differences in stroke or cardiovascular complications between the groups over the course of short-term and long-term follow-up.CONCLUSION:
Patients who undergo OPCABG and have CHF or a lower EF (<35%) are more likely to undergo on-pump conversion, while preoperative BB administration could help prevent conversions from OPCABG to on-pump CABG.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Cardiopulmonary Bypass
/
Drainage
/
Coronary Artery Bypass
/
Retrospective Studies
/
Risk Factors
/
Follow-Up Studies
/
Mortality
/
Myocardial Ischemia
/
Transplants
/
Stroke
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2017
Type:
Article
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