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Cirugía coronaria sin circulación extracorpórea después de 20 años. Resultado y seguimiento en 1.353 pacientes en el sur de Chile / Off pump coronary artery bypass surgery long term results after 20 years in a cardiac center in Chile
Bahamondes S, Juan Carlos.
  • Bahamondes S, Juan Carlos; Hospital Regional Temuco. Servicio de Cirugía Cardiovascular. Temuco. CL
Rev. méd. Chile ; 149(10): 1412-1422, oct. 2021. graf, tab
Article Dans Espagnol | LILACS | ID: biblio-1389365
ABSTRACT

BACKGROUND:

The benefits of off-pump coronary artery bypass graft (OPCAB) compared with conventional on-pump coronary artery bypass graft are not well established although several studies show excellent long-term results.

AIM:

To assess and report the long-term results of OPCAB surgery in a 20-year period in a Chilean Regional Cardiac Surgery Center. PATIENTS AND

METHODS:

Retrospective analysis of the medical records and surgical protocols of 1353 patients aged 61.3 ± 6.5 years, (69% males) subjected to OPCAB between June 1999 and December 2019.

RESULTS:

Thirty-four percent of patients presented with unstable angina. On angiography, the left main coronary artery had a proximal obstruction in 15% of patients. Thirty five percent presented with a myocardial infarction of different territories. Thirty percent of patients were managed previously with angioplasty. Preoperative left ventricular function was 45.3% (30-65%). The mean surgical risk Euroscore was 2.84. The mean number of bypasses was 2.7 ± 0.63. 2.6%. Conversion to on pump technique was required in 2.6% of patients. Operative mortality was 2%, myocardial infarction occurred in 3.4%, a new revascularization procedure was required in 2.3% and 2.4% of patients had a stroke. Long term follow up was complete in most patients and 93% are in NHYA functional capacity I. Actuarial survival was 100, 98, 89, 75 and 66% at 1, 5, 10, 15 and 20 years. Actuarial combined cardiovascular events free survival was 100, 98, 87, 68 and 51% at 1,5,10, 15 and 20 years.

CONCLUSIONS:

OPCAB surgery is a safe surgical technique, with an excellent bypass durability and permeability. It also provides a prolonged time free from cardiac events such as mortality, angina, myocardial infarction, and freedom from a new coronary procedure.
Sujets)


Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Pontage coronarien à coeur battant / Infarctus du myocarde Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle Pays comme sujet: Amérique du Sud / Chili langue: Espagnol Texte intégral: Rev. méd. Chile Thème du journal: Médicament Année: 2021 Type: Article Pays d'affiliation: Chili Institution/Pays d'affiliation: Hospital Regional Temuco/CL

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Pontage coronarien à coeur battant / Infarctus du myocarde Limites du sujet: Adulte très âgé / Femelle / Humains / Mâle Pays comme sujet: Amérique du Sud / Chili langue: Espagnol Texte intégral: Rev. méd. Chile Thème du journal: Médicament Année: 2021 Type: Article Pays d'affiliation: Chili Institution/Pays d'affiliation: Hospital Regional Temuco/CL