Document Detail


Does obesity affect operative times and perioperative outcome of patients undergoing totally endoscopic coronary artery bypass surgery?
MedLine Citation:
PMID:  19454414     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
More and more patients undergoing coronary artery bypass grafting (CABG) are overweight. This patient group suffers from wound healing problems more often than normal-weight patients. Therefore, avoiding sternotomy in obese patients by using an endoscopic technique could be a promising approach. Robotic technology enables totally endoscopic coronary artery bypass grafting (TECAB) procedures. We investigated whether the intra-operative-times or perioperative-outcome after TECAB-procedure are negatively affected by obesity. Patients [n=127, 101 male, 26 female, median age 59 (31-77) years], undergoing arrested-heart TECAB procedure were enrolled. The median body mass index (BMI) in this patient cohort was 26 (19-38). In detail, 27 patients were normal-weight (BMI <or= 25 kg/m(2)), 67 patients were overweight (BMI 25.1-30 kg/m(2)), 29 patients were obese (BMI 30.1-33.9 kg/m(2)) and four patients were morbidly obese (BMI >or= 34 kg/m(2)). There was no correlation between BMI (1) left internal mammary artery (LIMA) takedown-time [Spearman-rank correlation coefficient (R)=0.02; P=n.s.], (2) lipectomy and pericardiotomy-time (R=0.042, P=n.s.), (3) total operative-time (R=-0.083: P=n.s.), (4) cardiopulmonary-bypass-time (R=-0.012; P=n.s.), (5) aortic-endoocclusion-time (R=-0.055; P=n.s.), (6) mechanical-ventilation-time (R=0.001, P=n.s.), (7) length of ICU-stay (R=0.04; P=n.s.), (8) length of hospital-stay (R=-0.103; P=n.s.) or (9) occurrence of intra- and/or postoperative adverse events. In overweight, obese but also morbidly obese patients the TECAB procedure did not increase operative times or the rate of intra- or postoperative complications. This patient group, therefore, benefits from this less traumatic version of coronary surgery.
Authors:
Dominik Wiedemann; Thomas Schachner; Nikolaos Bonaros; Felix Weidinger; Christian Kolbitsch; Guy Friedrich; Günther Laufer; Johannes Bonatti
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-19
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  214-7     Citation Subset:  IM    
Affiliation:
Innsbruck Medical University, Innsbruck, Austria. dominik.wiedemann@i-med.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioscopy* / adverse effects
Body Mass Index
Cardiopulmonary Bypass
Coronary Artery Bypass / adverse effects,  methods*
Coronary Artery Disease / complications,  surgery*
Female
Heart Arrest, Induced
Humans
Intensive Care
Length of Stay
Lipectomy
Male
Middle Aged
Obesity / complications*
Obesity, Morbid / complications*
Overweight / complications*
Pericardiectomy
Respiration, Artificial
Retrospective Studies
Risk Assessment
Severity of Illness Index
Surgery, Computer-Assisted
Time Factors
Treatment Outcome

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


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