Document Detail

Off-pump coronary artery bypass is a safe option in patients presenting as emergency.
MedLine Citation:
PMID:  20838701     Owner:  NLM     Status:  In-Process    
INTRODUCTION: The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery.
MATERIALS AND METHODS: Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed.
RESULTS: Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4% vs 14.7%, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1% vs 35.3%, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9% vs 8.8%, P = 0.51) and required less inotropic support (66.2% vs 88.2%, P = 0.002), bloodtransfusions (23% vs 86.8%, P <0.0001), and atrial- (17.6% vs 35.3%, P = 0.02) or ventricular-pacing (17.6% vs 41.2%, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5% vs 94.1%, P = 0.004).
CONCLUSION: OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.
Eliana C Martinez; Maximilian Y Emmert; George N Thomas; Lorenz S Emmert; Chuen Neng Lee; Theo Kofidis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  39     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  607-12     Citation Subset:  IM    
Department of Surgery, National University of Singapore, Singapore, Singapore.
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