Off-pump coronary artery bypass grafting improves early clinical outcomes including operative mortality
| Autor: | Tomislov Kopjar, Madhu Ravisankar, Murali P. Vettath, A. V. Kannan, Nitin Gangadharan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Bypass grafting Patient risk medicine.medical_treatment Coronary Artery Bypass Off-Pump India Coronary Artery Disease coronary artery bypass grafting off pump coronary artery bypass beating heart surgery 030204 cardiovascular system & hematology Coronary Angiography 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Intraoperative Complications Adverse effect Stroke Retrospective Studies Off-pump coronary artery bypass business.industry Operative mortality Middle Aged medicine.disease Mediastinitis Surgery Survival Rate Treatment Outcome medicine.anatomical_structure 030228 respiratory system Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Forecasting Artery |
| Popis: | Background: Whether coronary artery bypass grafting (CABG) should be performed on- or off-pump remains a matter of debate. We aim to present our experience with off-pump CABG. Early clinical outcome and adverse events were analyzed over the time course of the study. Methods: A total of 4310 patients undergoing isolated off- pump CABG from January 2002 until December 2016 at the Malabar Institute of Medical Sciences in India were included. Preoperative, intraoperative, and postoperative, as well as follow-up data were prospectively collected. To analyze the differences of patient characteristics and outcomes over time, five-year periods were created (early: 2002-2006; middle: 2007-2011; late: 2012-2016). Traditional techniques of quality control monitoring were applied. Results: The mean age of our patients was 59 ± 9 years, and 13% (533) were female. Postoperative mortality was observed in 0.7% (25), acute renal failure and stroke in 0.2% (8) each, and mediastinitis in 1.2% (53) of the patients. Despite the progressive worsening of the patient risk profile, significant improvement in mortality was observed over time, while stroke, acute renal failure, and mediastinitis remained similar. Continuous quality control monitoring revealed that the system was within the control boundaries for the entire period of the study. The current probability of 30-day mortality or conversion to on-pump CABG is about 0.5%. Conclusion: Off-pump CABG is safe and effective for patients undergoing CABG. It can provide superior results compared to on-pump CABG, particularly when performed by a dedicated off-pump surgeon. |
| Databáze: | OpenAIRE |
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