Document Detail


Comparison of on pump and off pump coronary surgery: risk factors for neurological outcome.
MedLine Citation:
PMID:  17408960     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Cerebrovascular accidents (CVA) are devastating complications after coronary artery bypass grafting (CABG). The reported incidence of neurological complications after conventional CABG (CCABG) is 3-6%. Off-pump coronary bypass grafting (OPCAB) has been associated in recent studies to a decreased morbidity and risk of perioperative stroke. Nevertheless, uncertainty still surrounds the relative benefits of OPCAB. We investigated whether, in our experience, OPCAB was associated with lower neurological morbidity than conventional CABG approach. METHODS: Eight thousand and two patients underwent isolated CABG at our institution between January 1998 and January 2005. OPCAB operation was performed on 1415 patients. Data were prospectively collected. A multiple logistic regression analysis was used to evaluate the influence of the two different surgical techniques on the neurological outcomes. RESULTS: Patients in the OPCAB group were significantly older (66.2 vs 63.5%, p<0.0001), had a higher incidence of renal injury (5.4 vs 2.4%, p<0.0001), and were more redo interventions (6.95 vs 1.53%, p<0.0001). The CCABG patients were more urgent at operation (5.46 vs 3.26, p=0.0007), were less hypertensive (57.6 vs 63% of the patients, p=0.0003) more diabetics (22 vs 20.6%, NS), and had an ejection fraction less than 0.40 (10.4 vs 9.6%, NS). CVA incidence was similar in both groups (Type I outcome: OPCAB=0.70% vs CCABG=0.68%, p=0.91; Type II outcome OPCAB=0.70% vs CCABG=0.83%, p=0.63). CONCLUSIONS: In our experience patients undergoing CCABG were not exposed to a greater risk of neurological adverse events when compared to OPCAB patients.
Authors:
Erminio Sisillo; Maria Rosaria Marino; Glauco Juliano; Cristina Beverini; Luca Salvi; Francesco Alamanni
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-04-03
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  31     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-15     Completed Date:  2007-08-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1076-80     Citation Subset:  IM    
Affiliation:
Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiopulmonary Bypass
Coronary Artery Bypass / adverse effects,  methods*
Coronary Artery Bypass, Off-Pump / adverse effects,  methods
Female
Humans
Male
Middle Aged
Postoperative Complications / etiology*
Prospective Studies
Regression Analysis
Risk Factors
Stroke / etiology*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Salinity effects on polyphenol content and antioxidant activities in leaves of the halophyte Cakile ...
Next Document:  Allograft aortic root replacement in complex prosthetic endocarditis.