ABSTRACT
A consecutive cohort including 1080 patients undergoing "off-pump" myocardial revascularization was reviewed. An average of 2.22 bypass/patients was performed. The death-rate during the first 30 days after surgery was 0.65%. Four cases needed cross-over to on-pump. The postoperative events were: need of inotropic drugs (2.7%), atrial fibrillation (12.4%), myocardial infarction (6.6%). The extubation was performed before the first postoperative 24 h in 91.9% of cases. The majority of patients was discharged from hospital before 8 days after surgery. Off pump coronary artery bypass surgery exhibit good results for most of the patients even if they present multiple vessel disease and high operating risk.
Subject(s)
Coronary Artery Bypass, Off-Pump , Coronary Artery Disease/surgery , Adult , Aged , Aged, 80 and over , Cardiotonic Agents/administration & dosage , Cohort Studies , Coronary Artery Bypass, Off-Pump/adverse effects , Coronary Artery Bypass, Off-Pump/methods , Coronary Artery Disease/complications , Coronary Artery Disease/mortality , Female , Humans , Length of Stay , Male , Middle Aged , Myocardial Revascularization/methods , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
A consecutive series of 746 patients undergoing heart beating myocardial revascularization was reviewed. An average of 2.30 grafts/patients was performed. The rate of mortality in the first 30 postoperative days was 0.28%. Two cases had to be terminated on-pump. We used the inotropic drugs in 0.6% of cases. The postoperative events were: atrial fibrillation (12.6%), myocardial infarction (0.3%). The rate of transfusion was 7.4%. The extubation was performed in the first 24 h postoperatively in 94.7% of cases. The majority of patients (91.3%) left the hospital in the first 8 d postoperatively. Off pump coronary artery bypass grafting gives good result for the most of the patients even for those with multiple vessel disease and high operating risk.
Subject(s)
Coronary Artery Bypass/methods , Coronary Disease/surgery , Extracorporeal Circulation , Adult , Aged , Aged, 80 and over , Atrial Fibrillation/etiology , Coronary Disease/mortality , Female , Humans , Male , Middle Aged , Myocardial Contraction , Postoperative Complications/mortality , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
The aims of myocardial revascularisation are to treat angina, reduce ischaemia and improve life expectancy. Patients with multivessel disease have a poor prognosis, especially when the lesions are proximal, when the preseptal left anterior descending artery is involved and when left ventricular dysfunction is present. In this particular group of patients, coronary bypass surgery has been shown to improve 10 year survival. Coronary angioplasty has been compared with surgical treatment in many clinical trials. The medium-term survival is the same in both groups, but with a higher number of repeat procedures except in diabetic patients in whom mortality is higher after angioplasty. The use of coronary stents should reduce the number of post-angioplasty procedures. Constant technical improvements, the introduction of surgery without cardiopulmonary bypass, combined revascularisation procedures, new antiplatelet drugs, the absence of long-term comparative results, all this results in a personalized choice of revascularisation procedure based on the overall clinical and angiography features of each particular case.
