Document Detail

Comparison of off-pump and on-pump coronary endarterectomy for patients with diffusely diseased coronary arteries: early and midterm outcome.
MedLine Citation:
PMID:  25471231     Owner:  NLM     Status:  Publisher    
BackgroundCoronary endarterectomy (CE) is an alternative for the diffusely diseased left anterior descending (LAD), but its mid and long term results are largely questionable. This study is to compare the early to mid-term results between off-pump and on-pump coronary endarterectomy with coronary artery bypass grafting.Methods212 consecutive patients underwent CE and bypass grafting for diffusely diseased LAD. Ninety-two patients undergoing CE with off-pump (group off-pump) were compared with 120 patients undergoing CE with on-pump (group on-pump). The main preference for selection to an off-pump CE surgery were the preoperative high risk factors, especially previous cerebrovascular accident¿chronic obstructive pulmonary disease (COPD)¿calcified ascending aorta and right coronary artery(RCA) critical stenosis >90%.ResultsThere were three deaths in this group with total operative mortality of 1.4%. The perioperative mortality of group off-pump (1.1%) was similar with that of group on-pump (1.7%). The postoperative myocardial infarctions rate was 2.8%. There was no significant difference as for the morbidity between the group off-pump and group on-pump. Among survivors, the patency rate of the LIMA¿LAD anastomosis was 89.4%. There was no difference as for the grafts patency rate between the two groups. Kaplan¿Meier survival revealed no significant difference between the two groups. Kaplan-Meier freedom from cardiac events requiring hospital re-admission and angina recurrence were similar in both groups.ConclusionsOn-pump or off-pump CE is a good technique with the same early and mid-term outcomes. In the series of off-pump CE, we have shown that the effect of OPCABG with CE appears to be durable, and mid-term clinical outcomes are encouraging. Despite the higher risk profile, hospital mortality and major complications in our study are comparable to those for CCE.
Zhibing Qiu; Xin Chen; YingShou Jiang; LiMing Wang; Ming Xu; Fuhua Huang; Hongwei Shi; Cui Zhang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-4
Journal Detail:
Title:  Journal of cardiothoracic surgery     Volume:  9     ISSN:  1749-8090     ISO Abbreviation:  J Cardiothorac Surg     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-4     Completed Date:  -     Revised Date:  2014-12-5    
Medline Journal Info:
Nlm Unique ID:  101265113     Medline TA:  J Cardiothorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  186     Citation Subset:  -    
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