Conversion during off-pump coronary artery bypass graft surgery: A case–control study

Autor: Dattatreya Prabhakumar, Antony George, TA Patil, Vivek Jawali, Murali Chakravarthy
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_treatment
Coronary Artery Bypass
Off-Pump
Blood Pressure
030204 cardiovascular system & hematology
Revascularization
Balloon
Ventricular Function
Left
law.invention
lcsh:RD78.3-87.3
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
law
medicine
Cardiopulmonary bypass
Humans
Decompensation
Aged
Retrospective Studies
Intra-aortic balloon pump
Off-pump coronary artery bypass
Endarterectomy
Cardiopulmonary Bypass
Intra-Aortic Balloon Pumping
off-pump coronary artery bypass surgery
business.industry
Retrospective cohort study
Conversion
General Medicine
Length of Stay
Middle Aged
mortality
Surgery
Anesthesiology and Pain Medicine
intra-aortic balloon pump
lcsh:Anesthesiology
lcsh:RC666-701
Original Article
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Annals of Cardiac Anaesthesia, Vol 22, Iss 1, Pp 18-23 (2019)
Annals of Cardiac Anaesthesia
ISSN: 0971-9784
Popis: Objectives: Off pump coronary artery bypass (OPCAB) surgery is carried out as an alternative to conventional coronary artery bypass grafting using cardiopulmonary bypass (CPB). At times ‘conversion’ to CPB may be required to bail out a situation resulting from acute decompensation of the heart. It is reported that such conversion carries significant mortality risk. Since we conduct coronary revascularization by OPCAB technique as the preferred technique, we conducted this study with an aim to identify the markers of adverse outcome during conversion in Indian patients. Design: Case control retrospective study. Setting: Tertiary referral center. Participants: We conducted three thousand two hundred OPAB surgeries in the period between 2013 to16. Ninety patients (3.1%) required conversion to complete the revascularization (Con version group). Twice the number of patients who underwent OPCAB surgery without conver sion were chosen as controls (Control group). Intervention: OPCAB surgery Results: Mortality in the conversion group was 5.56% in contrast to 0.06% in the controls (P = 0.01). The conversion group had higher left ventricular end diastolic pressure, incidence of endarterectomy, and intra-aortic balloon counter pulsation requirement. Female gender was also predictive of conversion. The total chest drain, duration of ventilation, ICU stay and hospital stay were also higher in the conversion group. Conversion was associated with 9.47 times the odds for mortality. Conclusion: Conversion during OPCAB is associated with significantly increased mortality. Female gender, increased left ventricular end diastolic pressure and preoperative requirement of Intra-aortic balloon are markers of increased risk of mortality when converted.
Databáze: OpenAIRE
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