Incidence of perioperative stroke in clampless aortic anastomosis during off-pump coronary artery bypass grafting
| Autor: | Giuseppe Tata, Francesco Formica, Giovanni Paolini, Stefano D'Alessandro, Gurmeet Singh, Serena Mariani, Luigi Amerigo Messina, Fabio Sangalli |
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| Přispěvatelé: | Formica, F, Tata, G, Singh, G, Mariani, S, D’alessandro, S, Messina, L, Sangalli, F, Paolini, G |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Artery Bypass Off-Pump Aorta Thoracic 030204 cardiovascular system & hematology Anastomosis 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Off-pump surgery Clampless anastomosi medicine Humans Hospital Mortality CABG Stroke Aged Retrospective Studies Off-pump coronary artery bypass Aged 80 and over business.industry Incidence Incidence (epidemiology) Anastomosis Surgical Retrospective cohort study Vascular surgery medicine.disease Coronary Vessels Cardiac surgery Survival Rate medicine.anatomical_structure Italy 030228 respiratory system Anesthesia Female Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Heart and Vessels. 33:595-604 |
| ISSN: | 1615-2573 0910-8327 |
| DOI: | 10.1007/s00380-017-1106-0 |
| Popis: | This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed. In-hospital mortality was lower into No-touch group compared with HS group but without significant statistical difference (1.7 vs. 3.2%, p = 0.19, respectively); the rate of postoperative stroke was higher in No-touch group compared with HS group, although this difference did not reach statistically significance. Delirium was reported with higher presentation rate in HS group (3.9 vs. 0.8%, p = 0.01). Blood transfusions rate was higher in HS subjects (23.4 vs. 16.1%, p = 0.01). Intubation time, ICU, and hospital length of stay were increased in the HS group (p = 0.008, p = 0.001 and p = 0.003, respectively). Over a 12-year follow-up period, survival probabilities at 1, 5, and 10 years were 93.6 ± 1.3 vs. 93.2 ± 1.5, 80.4 ± 2.6 vs. 80.3 ± 2.2, and 57.9 ± 5 vs. 58.4 ± 3.8% in the No-touch and HS group, respectively (p = 0.97). In this retrospective study, clampless off-pump CABG lowers perioperative stroke rate whose incidence is, however, not inferior compared with No-touch technique, and no statistically significance was detected. Delirium has a higher presentation rate in clampless off-pump CABG. |
| Databáze: | OpenAIRE |
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