| Clinical outcomes of on-pump coronary bypass using heparin-bonded circuits and reduced anti-coagulation compare favorably with off-pump approach. | |
| | |
MedLine Citation:
|
PMID: 11958309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), or off pump, has gained popularity by avoiding the postoperative morbidity related to the use of CPB. Previously, we have demonstrated that CABG done on pump using heparin-bonded cardiopulmonary bypass circuits (HBC) with a lower anti-coagulation protocol (LAP) attenuates these effects, reduces homologous blood product requirement, and improves clinical outcome when compared with conventional CPB circuits. Our purpose in this study was to compare off-pump CABG clinical outcomes to on-pump CABG using HBC with LAP. We retrospectively analysed preoperative and postoperative variables of all primary CABG (n=1214) performed at this institution from 1 January 1997 to 28 July 2000. These patients were divided into the on-pump (n=1152) and off-pump groups (n=62). HBC with LAP were used in all on-pump CABG cases. There was no statistical difference in preoperative comorbid risk factors except percentage of females (on pump, 30% vs. off pump, 44%; p=0.02) and body surface area (on pump, 1.94 +/- 0.25 ml vs. off pump, 1.85 +/- 0.22 ml; p=0.02). There was no difference in intraoperative and postoperative complications, risk-adjusted mortality, total blood product usage, or length of stay. The mean number of distal anastomoses performed was significantly different (on pump, 3.5 +/- 0.82 vs. off pump 1.8 +/- 0.82; p < 0.001). Despite similar preoperative risk factors, clinical outcomes and homologous blood requirements were not statistically different between the off-pump and on-pump groups. These endpoints should not be the only criteria to justify performing off-pump CABG. |
| | |
Authors:
|
Paul J O'Gara; Vijay Natarajan; Kevin Lilly; Ali Husain; Oz M Shapira; Richard J Shemin |
Related Documents
:
|
9628379 - Should coronary artery bypass grafting be performed at the same time as repair of a pos... 15801059 - Bypass graft imaging and coronary anomalies in mdct. 10844629 - Predicting acute renal failure after coronary bypass surgery: cross-validation of two r... 12203069 - Laparoscopic cholecystectomy after coronary artery bypass grafting using the right gast... 8297279 - Coronary artery surgery in the elderly: long-term follow-up. 8469339 - Brain magnetic resonance imaging in coronary artery bypass grafts: a pre- and postopera... 22347659 - Modification of a volume-overload heart failure model to track myocardial remodeling an... 11136349 - Transcranial colour-coded sonography for the bedside evaluation of mass effect after st... 1464339 - Improved diastolic function with the calcium antagonist nisoldipine (coat-core) in pati... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Perfusion Volume: 17 ISSN: 0267-6591 ISO Abbreviation: Perfusion Publication Date: 2002 Mar |
Date Detail:
|
Created Date: 2002-04-17 Completed Date: 2003-07-24 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8700166 Medline TA: Perfusion Country: England |
Other Details:
|
Languages: eng Pagination: 91-4 Citation Subset: IM |
Affiliation:
|
Boston Medical Center, Massachusetts 02118, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anticoagulants / administration & dosage Coated Materials, Biocompatible / chemistry* Coronary Artery Bypass / instrumentation, methods*, mortality Female Heparin* Hospital Mortality Humans Male Middle Aged Perfusion / instrumentation, methods Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Coated Materials, Biocompatible; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A 10-year review of pediatric perfusion practice in North America.
Next Document: Heparin-bonded circuits without a cardiotomy: a description of a minimally invasive technique of car...