| Coronary reoperation with and without cardiopulmonary bypass. | |
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MedLine Citation:
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PMID: 16598517 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Redo coronary artery bypass grafting (CABG) is still associated with increased morbidity and mortality compared to primary operation. Myocardial protection is one of the key issues in redo on pump CABG and is still a matter of debate. Off pump redo CABG seems to be an attractive alternative as native coronary blood flow remains and cross clamping of the aorta is avoided. The aim of this retrospective study was to compare the outcome of redo CABG with and without CPB. From 1/1998 to 5/2004 redo CABG was performed in 195 patients (pts): 162 male (83.1%) and 33 female (16.9%) pts, age 66 +/- 9 years. In 160 pts, CPB with isolated antegrade myocardial protection was used for redo CABG. Off pump redo CABG was performed in 35 pts (30 male (85.7%) and 5 female (14.3%), age 67 +/- 8 years). Perioperative overall mortality rate was 3.6% (n = 7) and comparable in both groups (on pump 3.8% versus off pump 2.9%; p = 0.90), as well as perioperative myocardial infarction, intraaortic balloon pump implantation rate and secondary morbidity. Complete revascularization was achieved in 139 pts (86.9%) after on pump CABG and in 17 pts (48.6%) of the off pump group (p < 0.01). The average number of grafts was significantly higher in the on pump group (2.8 +/- 0.78 versus 1.6 +/- 0.6; p = 0.04).Furthermore, 20 pts (12.5%) in the on pump group died during follow-up (50 +/- 16 months). Five pts (25.0%) died due to cardiac reasons. In the off pump group 3 pts (8.6%) died during follow-up (44 +/- 13 months), noncardiac related. Overall survival was 83.8% in the on pump group and 88.6% in the off pump group (p = 0.92). On pump redo CABG and off pump redo CABG can be safely performed with low mortality and morbidity. Off pump redo CABG might be limited due to incomplete revascularization. |
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Authors:
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S M Tugtekin; K Alexiou; U Kappert; H Esche; D Joskowiak; M Knaut; K Matschke |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical research in cardiology : official journal of the German Cardiac Society Volume: 95 ISSN: 1861-0684 ISO Abbreviation: - Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-04-06 Completed Date: 2006-06-30 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 101264123 Medline TA: Clin Res Cardiol Country: Germany |
Other Details:
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Languages: eng Pagination: 93-8 Citation Subset: IM |
Affiliation:
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Dep. of Cardiac Surgery, Heart Center Dresden University Hospital, Fetscherstr. 76, 01307 Dresden, Germany. stugtekin@herzzentrum-dresden.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass Coronary Artery Bypass* Coronary Artery Bypass, Off-Pump Coronary Disease / mortality, surgery* Female Humans Male Middle Aged Reoperation Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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