Document Detail


Deep pericardial sling versus lateral pericardial sutures in off-pump coronary artery bypass surgery.
MedLine Citation:
PMID:  20354498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The aim of this study was to evaluate the safety and efficacy of deep pericardial sling (DPS) versus lateral pericardial sutures (LPSs) for heart stabilization and adequate coronary artery exposure during off-pump coronary artery bypass surgery (OPCAB). METHODS: One surgeon employed in 101 consecutive patients a series of four to six 2-0 polyglactin sutures placed laterally between the left phrenic nerve and the left pulmonary veins (LPS). Two other surgeons used in 104 consecutive patients a single 0-0 braided silk suture with moistened gauze placed in the oblique sinus of the posterior pericardium, between the inferior vena cava and the right lower pulmonary vein (DPS). RESULTS: One conversion to beating heart surgery with cardiopulmonary bypass support occurred in each study group. No patient in the LPS group was converted to DPS technique. The use of LPSs allowed a number of distal anastomoses somewhat higher than the DPS technique (4.1+/-1.1 vs. 3.7+/-1.1, P=0.02). Postoperative results were similar in both study groups. A lower incidence of postoperative low-cardiac output syndrome and of prolonged need of inotropes has been observed in the LPS group, but the difference failed to reach statistical significance. One patient in the LPS group had postoperative left phrenic nerve palsy. One patient in the DPS group suffered of intraoperative bleeding secondary to rupture of the inferior vena cava likely related to placement of DPS, which was successfully repaired. CONCLUSION: LPS technique is as effective as DPS technique and allows complete revascularization with a postoperative outcome similar to the latter technique.
Authors:
F Biancari; A Rainio; M Mosorin; P Taskinen; H Pihkakoski; J Lahtinen; M Lepojärvi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  51     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-31     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  273-5     Citation Subset:  IM    
Affiliation:
Division of Cardio-Thoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland. faustobiancari@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass, Off-Pump* / adverse effects
Equipment Design
Female
Humans
Male
Middle Aged
Pericardium / surgery*
Polyglactin 910
Retrospective Studies
Risk Assessment
Silk
Suture Techniques* / adverse effects,  instrumentation
Sutures
Treatment Outcome
Chemical
Reg. No./Substance:
0/Silk; 34346-01-5/Polyglactin 910

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


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