Document Detail


Early and midterm outcome after off-pump coronary artery bypass grafting in patients with poor left ventricular function compared with patients with normal function.
MedLine Citation:
PMID:  18607678     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: As there are few reports on the clinical results of off-pump coronary artery bypass (OPCAB) in patients with poor left ventricular (LV) function, the safety and efficacy of OPCAB surgery in such patients remains unclear. METHODS: From January 2002 to May 2007, a total of 519 consecutive patients underwent isolated myocardial revascularization via OPCAB. We compared the early and midterm results of 79 patients with poor LV function [ejection fraction (EF) < 40%] with those of 319 patients with normal LV function (EF >or= 50%). Follow-up was completed in 96.2% of the patients. RESULTS: There were no significant intergroup differences in the number of grafts per patient or the rate of achievement of complete revascularization. No patient in either group was converted from off-pump to on-pump. The overall 30-day mortality was 1.0%. The mean follow-up was 3.0 +/- 1.3 years. Five-year freedom from death from all causes was 57.7% in the low-EF group and 83.6% in the normal-EF group. The rates of freedom from cardiac death were 73.2% and 93.7%, respectively; and the rates of freedom from the combined endpoint of cardiac death, myocardial infarction, repeat coronary intervention, and heart failure requiring treatment were 65.7% and 77.3%, respectively. CONCLUSION: OPCAB surgery in patients with poor LV function can be performed safely with the same quality in terms of the number of grafts and rate of complete revascularization as in patients with normal LV function. There are higher mortality and cardiac event rates in patients with poor LV function than those with normal LV function at the midterm evaluation after OPCAB.
Authors:
Tomoaki Suzuki; Tohru Asai; Keiji Matsubayashi; Atsushi Kambara; Hirohisa Ikegami; Takeshi Kinoshita; Osamu Nishimura
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-07-08
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  56     ISSN:  1863-6705     ISO Abbreviation:  -     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  324-9     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Ootsu, Shiga, Japan. suzukit@belle.shiga-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass, Off-Pump* / adverse effects
Coronary Artery Disease / mortality,  physiopathology,  surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Stroke Volume
Survival Rate
Time Factors
Treatment Outcome
Ventricular Function, Left*

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


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