Document Detail


Off-pump bypass grafting is safe in patients with left main coronary disease.
MedLine Citation:
PMID:  11565659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Because of a concern about the ability to tolerate beating heart grafting, patients with left main coronary artery stenosis have been excluded from off-pump bypass. We reviewed our experience with off-pump coronary artery bypass grafting for patients with left main coronary artery disease. METHODS: Eight hundred twenty-three patients underwent bypass grafting for left main coronary artery disease from January 1998 to October 1999. One hundred patients were revascularized without the use of cardiopulmonary bypass and compared with a contemporaneous cohort of 723 patients who underwent grafting with the aid of cardiopulmonary bypass. All patients had multivessel grafting performed through a sternotomy. RESULTS: There was one death (1%) in the group undergoing off-pump grafting as compared with a 30-day mortality of 4.7% (p = 0.059) in the on-pump group. Univariate analysis established that patients revascularized without cardiopulmonary bypass were significantly less likely to require postoperative inotropic support (23% versus 62%, p < 0.001) and transfusion (35% versus 67%, p < 0.001). Logistic regression analysis revealed that cardiopulmonary bypass was an independent risk factor for mortality (odds ratio, 7.3; 95% confidence interval, 1.34 to 138.4). CONCLUSIONS: Coronary artery bypass grafting using off-pump techniques are safe and effective in left main coronary artery disease.
Authors:
T M Dewey; M J Magee; J R Edgerton; M Mathison; D Tennison; M J Mack
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  72     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-21     Completed Date:  2001-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  788-91; discussion 792     Citation Subset:  AIM; IM    
Affiliation:
Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA. tdewey@csant.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiopulmonary Bypass* / adverse effects
Coronary Artery Bypass* / adverse effects
Coronary Disease / surgery*
Female
Humans
Male
Middle Aged
Postoperative Complications
Risk Factors

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


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