Document Detail


Role of cardiopulmonary bypass in single vessel coronary revascularization: implications for MID-CABG.
MedLine Citation:
PMID:  11276443     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Minimally invasive direct coronary artery bypass grafting (MID-CABG) is being utilized for the treatment of coronary artery disease in selected patients. This innovative procedure has generated numerous technical issues relating to coronary revascularization, including whether to perform the revascularization with or without cardiopulmonary bypass (CPB). METHODS: We addressed this issue indirectly by analyzing the 1995 New York State CABG registry, comparing patients who had single vessel bypass without CPB (Non-CPB Group) to a similar cohort of patients who had CABG performed on CPB (CPB Group). The database showed stratification of patients selected for bypass grafting without CPB to a significantly higher risk group, as shown by increased age, higher incidence of reoperation, transmural MI, congestive heart failure, carotid/cerebrovascular disease, and peripheral vascular disease. RESULTS: Patients in the Non-CPB Group had a higher incidence of postoperative malignant ventricular arrhythmias and heart block requiring pacemaker insertion. Otherwise, the incidence of postoperative complications was similar between the two groups. CONCLUSIONS: There were no statistical differences in the hospital mortality or the length of hospitalization between the two groups. In conclusion, the data showed a definite trend toward doing higher risk cases off CPB. These cases had an acceptable early morbidity and mortality outcome. The results were comparable to a group of lower risk patients with single vessel CABG done on cardiopulmonary bypass. However, further follow-up are required to evaluate long-term outcomes and confirm the utility of this surgical option.
Authors:
R John; A F Choudhri; W Ting; C R Smith; E A Rose; M C Oz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  1     ISSN:  1098-3511     ISO Abbreviation:  Heart Surg Forum     Publication Date:  1998  
Date Detail:
Created Date:  2001-04-02     Completed Date:  2001-05-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-70     Citation Subset:  IM    
Affiliation:
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass / methods*,  mortality*,  statistics & numerical data
Coronary Artery Bypass / methods*,  mortality*,  statistics & numerical data
Coronary Disease / surgery
Graft Rejection
Graft Survival
Humans
Male
Middle Aged
Myocardial Revascularization / methods,  mortality
New York
Postoperative Complications / mortality
Probability
Reference Values
Registries
Severity of Illness Index
Surgical Procedures, Minimally Invasive / methods*,  mortality*
Survival Rate
Treatment Outcome

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


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