Symptom progression following on-pump versus off-pump coronary artery bypass graft surgery in patients with peripheral arterial disease.

Autor: Sevuk U; Department of Cardiovascular Surgery, Bower Hospital, Diyarbakir, 21300, Turkey., Bahadir MV; Division of Transplantation, Dicle University, Organ Nakli Klinigi, Yenişehir, Silvan Yolu, Diyarbakir, 21100, Turkey. mvbahadir@hotmail.com.
Jazyk: angličtina
Zdroj: General thoracic and cardiovascular surgery [Gen Thorac Cardiovasc Surg] 2023 Mar; Vol. 71 (3), pp. 158-166. Date of Electronic Publication: 2022 Aug 09.
DOI: 10.1007/s11748-022-01855-x
Abstrakt: Objective: This study aims to examine whether cardiac surgery leads to symptom progression in the early postoperative period in patients with the peripheral arterial disease (PAD) and evaluate the difference between on-pump (OPCAB) and off-pump (ONCAB) coronary artery bypass graft surgery with regard to the symptom progression.
Methods: This retrospective study included one hundred consecutive adult patients with PAD at Fontaine stage 2b (pain-free walking distance less than 100 m) undergoing ONCAB and one hundred consecutive adult patients with PAD at Fontaine stage 2b (pain-free walking distance less than 100 m) undergoing OPCAB. Symptom progression was defined as the development of ischemic rest pain (Fontaine stage 3).
Results: In the first week after surgery, 12 patients in the OPCAB group and 53 patients in the ONCAB group had postoperative symptom progression (p < 0.001). Rest pain resolved in most of these patients on the 15th postoperative day. At the end of the second month, rest pain resolved in all patients. Logistic regression analysis revealed that cardiac surgery with CPB, ABI < 0.5, postoperative nadir hct levels ≤ 25%, and intraoperative tissue hypoxia were independently associated with postoperative symptom progression.
Conclusions: In summary, we found that cardiac surgery may lead to symptom progression in patients with severe claudication in the early postoperative period. Our results suggest that OPCAB may lead to lower rates of symptom progression compared to ONCAB.
(© 2022. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.)
Databáze: MEDLINE
Externí odkaz: