| Five years follow-up after Y-graft arterial revascularization: on pump versus off pump; prospective clinical trial. | |
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MedLine Citation:
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PMID: 19995794 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We report our comparative experience of on-pump and off-pump full arterial coronary artery bypass grafting (CABG) using both internal mammary arteries (IMAs) anastomosed as a Y-graft. METHODS: A single-center clinical study was conducted prospectively between January 2003 and May 2008. It compared the short- and mid-term clinical outcomes of on- and off-pump arterial revascularization where the left internal mammary artery (LIMA) was anastomosed to the left anterior descending (LAD) artery while the free right internal mammary artery (RIMA) graft taking off from the LIMA was used to bypass different coronary targets. RESULTS: One hundred and ninety-two patients were divided into 77 on-pump and 115 off-pump procedures based on the intention to treat. The mean age in both groups was 60.2+/-11.7 and 68.1+/-10.6 years, respectively (P<0.05). Mean predictive logistic EuroSCORE was 3.5+/-6.7% for the on-pump group and 7.3+/-8.6% for the off-pump group (P<0.0001). Mean number of distal anastomoses were 2.7+/-0.6 (group ON) and 2.5+/-0.6 (group OFF) (P=NS). Postoperative mortality was two patients (2.6%) in the on-pump group and four patients (3.4%) in the off-pump group (P=0.63). No major adverse cardiac event, no stroke and no late death were reported during the follow-up that averaged 36.5+/-18.6 months. Angina recurrence was three patients (2.6%) in off-pump and two patients (3.5%) in on-pump group (P=NS). CONCLUSIONS: The use of a free RIMA as Y-graft from the LIMA performed off pump eradicates aortic manipulations and provides complete revascularization to high-risk patients with mortality similar to the one of a lower risk population operated on pump. The morbidity and cost was lower in the off-pump group. This advocates for the widespread usage of the technique in high-risk patients. |
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Authors:
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Ahmed S E Ramadan; Constantin Stefanidis; William N'Gatchou; Bachar El Oumeiri; Jean-Luc Jansens; Jean-Marie De Smet; Martine Antoine; Didier De Canni?re |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article Date: 2009-12-08 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 10 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-26 Completed Date: 2010-06-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 423-7 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Erasme Hospital, University of Brussels (ULB), Route de Lennik, Brussels, Belgium. ahmad_sabry_cts@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass* / adverse effects, economics, mortality Chi-Square Distribution Coronary Artery Bypass, Off-Pump* / adverse effects, economics, mortality Coronary Artery Disease / economics, mortality, surgery* Cost Savings Cost-Benefit Analysis Female Follow-Up Studies Health Care Costs Humans Internal Mammary-Coronary Artery Anastomosis* / adverse effects, economics, mortality Logistic Models Male Middle Aged Patient Selection Prospective Studies Recurrence Risk Assessment Risk Factors Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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