Nicorandil Infusion During Off-Pump Coronary Artery Bypass Grafting Reduces Incidence of Intra-aortic Balloon Pump Insertion
| Autor: | Kakalee K. Saha, Rinu V. Jacob, Lukash Jagdale, Shibban K. Kaul, Kamales Kumar Saha, Mandar Deval, Ashok Kumar |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Bypass grafting Grafting (decision trees) medicine.medical_treatment Coronary Artery Bypass Off-Pump 030204 cardiovascular system & hematology Intra-Aortic Balloon Pumping 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Internal medicine medicine Humans Nicorandil Off-pump coronary artery bypass Intra-aortic balloon pump Aged Retrospective Studies Intraoperative Care business.industry Incidence (epidemiology) Incidence General Medicine Middle Aged medicine.anatomical_structure Treatment Outcome 030228 respiratory system cardiovascular system Cardiology Surgery Administration Intravenous Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Artery medicine.drug |
| Zdroj: | Innovations (Philadelphia, Pa.). 11(2) |
| ISSN: | 1559-0879 |
| Popis: | Objective Off-pump coronary artery bypass grafting in patients with left ventricular dysfunction has proven to be advantageous. However, it carries risk of emergency conversion to cardiopulmonary bypass. We have successfully used an intra-aortic balloon pump to prevent such conversion. The objective of the present study was to evaluate if intravenous nicorandil infusion reduces the incidence of intraoperative intra-aortic balloon pump insertion. Methods Consecutive cases of isolated off-pump coronary artery bypass surgery performed by a single surgeon were studied. Patients were divided into two groups. The first group did not receive nicorandil, and the second group received intraoperative nicorandil infusion (started in the operating room after central line insertion). Results A total of 375 patients were included in the study. Four patients in the non-nicorandil group and the patients in nicorandil group were on preoperative intra-aortic balloon pump and hence excluded from the study. After routine use of nicorandil infusion, incidence of intra-aortic balloon pump insertion during off-pump coronary artery bypass surgery decreased from 12.4% (21/169) to 2.9% (6/206). Conclusions Nicorandil infusion significantly (P = 0.007) reduced the incidence of intra-aortic balloon pump insertion in our series. In patients with left ventricular dysfunction (ejection fraction ≤ 30%), this difference (P = 0.008) assumes a special significance as off-pump bypass surgery is considered high risk in this subset. Nicorandil is an inexpensive drug, and the reduction in cost of surgery by avoiding intra-aortic balloon pump insertion is an added advantage. The use of nicorandil infusion during off-pump coronary artery bypass may result in favorable patient outcomes by reducing invasive intra-aortic balloon pump insertion during off-pump coronary artery bypass grafting. |
| Databáze: | OpenAIRE |
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