| Have improvements in myocardial protection influenced a surgeon's choice of coronary artery bypass surgery? | |
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MedLine Citation:
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PMID: 20233803 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study is to determine whether improvements in myocardial protection strategy have influenced the surgeon's choice of coronary artery bypass surgery. Between February 2002 and April 2009, a total of 662 patients underwent coronary artery bypass surgery under the provision of a single consultant surgeon. Operative mortality was defined as in-hospital death and comparison was made based on both the observed and expected mortalities as derived from the logistic EuroSCORE. Of the 662 patients who underwent cardiac surgery, 155 had off-pump whilst 507 had conventional coronary artery bypass surgery. The observed mortalities improved over the years in line with the improvements in myocardial protection strategy despite the increasing risk as predicted by the logistic EuroSCORE, with a reduction in the ratio of observed to expected mortalities of 1.2 in the off-pump group to 0.4 in the conventional group who had better myocardial protection. This has lead to a change in practice being predominantly off-pump at the beginning to that of conventional surgery in the later part of the study. As the case mix of patients gets worse with the increasing severity of multi-vessel disease and poor ventricular function, myocardial protection becomes crucial to the surgeon's preoperative assessment. |
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Authors:
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Reubendra Jeganathan; Gianfranco Campalani |
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Publication Detail:
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Type: Journal Article Date: 2010-03-16 |
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 Jun |
Date Detail:
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Created Date: 2010-05-18 Completed Date: 2010-08-24 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: 855-8 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Ground Floor West Wing, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK. reubenj@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Choice Behavior* Coronary Artery Bypass / adverse effects, methods*, mortality Coronary Artery Bypass, Off-Pump* / adverse effects, mortality Female Heart Arrest, Induced* / adverse effects, mortality Heart Diseases / etiology, mortality, prevention & control* Hospital Mortality Humans Logistic Models Male Middle Aged Northern Ireland Patient Selection* Physician's Practice Patterns* / statistics & numerical data Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Interact Cardiovasc Thorac Surg. 2010 Jun;10(6):858
[PMID:
20479067
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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