Document Detail


Have improvements in myocardial protection influenced a surgeon's choice of coronary artery bypass surgery?
MedLine Citation:
PMID:  20233803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Reubendra Jeganathan; Gianfranco Campalani
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Publication Detail:
Type:  Journal Article     Date:  2010-03-16
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  855-8     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Ground Floor West Wing, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK. reubenj@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
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:
Interact Cardiovasc Thorac Surg. 2010 Jun;10(6):858   [PMID:  20479067 ]

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


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