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Difference Between Cardiopulmonary Bypass Time and Aortic Cross-Clamping Time as a Predictor of Complications After Coronary Artery Bypass Grafting.
Jucá, Fabiano Gonçalves; Freitas, Fabiane Letícia de; Goncharov, Maxim; Pes, Daniella de Lima; Jucá, Maria Eduarda Coimbra; Dallan, Luis Roberto Palma; Lisboa, Luiz Augusto Ferreira; Jatene, Fábio B; Mejia, Omar Asdrúbal Vilca.
Afiliação
  • Jucá FG; Department of Cardiovascular Surgery, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.
  • Freitas FL; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Goncharov M; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Pes DL; Instituto de Pesquisa Hcor, Hospital do Coração, São Paulo, São Paulo, Brazil.
  • Jucá MEC; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Dallan LRP; Faculdade de Medicina, Unichristus, Fortaleza, Ceará, Brazil.
  • Lisboa LAF; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Jatene FB; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Mejia OAV; Department of Cardiovascular Surgery, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Braz J Cardiovasc Surg ; 39(2): e20230104, 2024 Mar 01.
Article em En | MEDLINE | ID: mdl-38426431
ABSTRACT

INTRODUCTION:

Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood.

OBJECTIVE:

To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II.

METHODS:

Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome.

RESULTS:

After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio 1.64, 95% confidence interval 1.01-2.66), stroke (odds ratio 3.85, 95% confidence interval 1.99-7.63), kidney failure (odds ratio 1.90, 95% confidence interval 1.32-2.74), and in-hospital mortality (odds ratio 2.17, 95% confidence interval 1.30-3.60).

CONCLUSION:

TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ponte Cardiopulmonar / Insuficiência Renal Limite: Humans Idioma: En Revista: Braz J Cardiovasc Surg Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ponte Cardiopulmonar / Insuficiência Renal Limite: Humans Idioma: En Revista: Braz J Cardiovasc Surg Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil