Myocardial revascularization in the elderly using beating heart coronary artery bypass surgery
| Autor: | Jon F. Moran, J.Mark Williams, Joseph R Elbeery, Nicola A Francalancia, W. Randolph Chitwood, Theodore C. Koutlas |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Population law.invention Coronary artery bypass surgery Postoperative Complications Risk Factors law Internal medicine Atrial Fibrillation Cardiopulmonary bypass Humans Medicine Blood Transfusion Thoracotomy Derivation Coronary Artery Bypass education Aged education.field_of_study business.industry Atrial fibrillation Perioperative Length of Stay medicine.disease Surgery Median sternotomy Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 69:1042-1047 |
| ISSN: | 0003-4975 |
| Popis: | Beating heart or "off-pump" coronary artery bypass (OP-CAB) has become an accepted method of myocardial revascularization by reducing the perioperative morbidity related to cardiopulmonary bypass (CPB). However, the efficacy of OP-CAB has not been well established in the elderly patient population.OP-CABs were performed in 53 patients aged 75 years and older, at Pitt County Memorial Hospital from January 1996 to October 1999, either through a median sternotomy or an anterior thoracotomy. These results were compared with 220 patients who underwent standard coronary artery bypass graft (CABG) operation using CPB during the same time period.Mean patient age for both groups was 79+/-0.5 years and preoperative risk factors were similar. There were no differences in postoperative myocardial infarction, atrial fibrillation, bleeding, neurologic complications, or renal failure. There were no deaths after OP-CAB, compared with the 7.6% operative mortality rate after CABG (p0.05). The OP-CAB group had a significantly shorter postoperative length of stay (4.4+/-0.4 days vs. 8.4+/-0.6 days) and lower transfusion requirements (0.4+/-0.1 units packed red blood cells vs 1.9+/-0.2 units packed red blood cells) than the CABG group.Our data demonstrate that OP-CAB is a safe and efficacious method of myocardial revascularization in the elderly, and may actually be preferential in these patients when applicable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|