| Early and mid-term impacts of cardiopulmonary bypass on coronary artery bypass grafting in patients with poor left ventricular dysfunction: a propensity score analysis. | |
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MedLine Citation:
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PMID: 17721016 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiopulmonary bypass may exacerbate myocardial damage in compromised left ventricles. Early and mid-term outcomes of off-pump coronary artery bypass grafting (OPCAB) vs on-pump coronary artery bypass grafting (On-pump CABG) were compared in patients with poor left ventricular dysfunction, using an analysis of a propensity score matching. METHODS AND RESULTS: Between December 2000 and November 2005, 1,473 patients underwent isolated coronary artery bypass grafting in our institute and 153 patients who had a left ventricular ejection fraction (LVEF) lower than 35% were enrolled. The OPCAB group contained 100 patients and the On-pump CABG group contained 53 patients. Preoperative risk factors were compared and 50 patients in each group were matched. The mean follow-up time was 35.5+/-17.3 months. Three deaths (3.0%) occurred in the matched cohort, with no significant difference between 2 groups. The operation time, ventilation time, intensive care unit admission time and occurrence of respiratory failure were significantly lower in the OPCAB group. The mean LVEF of the 2 groups improved significantly. The overall 6-year actuarial survival rates of the OPCAB and On-pump CABG group were 88.2% and 72.4% (p=0.2), respectively, and there were no significant differences in 6-year rates of freedom from major adverse cardiac and cerebrovascular events (p=0.97). CONCLUSIONS: Coronary artery bypass grafting in patients with poor left ventricular dysfunction improved myocardial function. Postoperative respiratory failure was significantly related to the cardiopulmonary bypass for surgical myocardial revascularization. Off-pump and On-pump surgical revascularization resulted in equivalent mid-term outcomes. |
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Authors:
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Young-Nam Youn; Byung-Chul Chang; You-Sun Hong; Young-Lan Kwak; Kyung-Jong Yoo |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 71 ISSN: 1346-9843 ISO Abbreviation: Circ. J. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-27 Completed Date: 2007-12-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 1387-94 Citation Subset: IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass* Coronary Artery Bypass* Disease-Free Survival Female Follow-Up Studies Humans Intensive Care Male Middle Aged Postoperative Period Respiratory Insufficiency / etiology, mortality Retrospective Studies Risk Factors Survival Rate Time Factors Ventricular Dysfunction, Left / complications, mortality, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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