Off-pump coronary artery bypass is a safe option in patients presenting as emergency
Annals of the Academy of Medicine, Singapore
; : 607-612, 2010.
Article
in En
| WPRIM
| ID: wpr-234085
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery.</p><p><b>MATERIALS AND METHODS</b>Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed.</p><p><b>RESULTS</b>Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4% vs 14.7%, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1% vs 35.3%, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9% vs 8.8%, P = 0.51) and required less inotropic support (66.2% vs 88.2%, P = 0.002), bloodtransfusions (23% vs 86.8%, P <0.0001), and atrial- (17.6% vs 35.3%, P = 0.02) or ventricular-pacing (17.6% vs 41.2%, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5% vs 94.1%, P = 0.004).</p><p><b>CONCLUSION</b>OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.</p>
Full text:
1
Index:
WPRIM
Main subject:
Safety
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Singapore
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General Surgery
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Time Factors
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Coronary Artery Disease
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Odds Ratio
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Coronary Artery Bypass
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Retrospective Studies
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Statistics as Topic
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Cohort Studies
Type of study:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Female
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Humans
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Male
Country/Region as subject:
Asia
Language:
En
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2010
Type:
Article