ABSTRACT
Objective Through compare the clinical data of two kinds of coronary bypass operation under Extacorpeal circulation and Non extracorpoeal circulation in patients over 70 years old with triple-vessel disease, and to provide the clinicalexperience. Methods Choose the patients hospitalized from Department of thoracic sur-gery 115 cases who had had coronary arterybypass grafting surgery from January 2014 to June 2017.there were 51 cases accepted Extracorporeal circulation surgery,Another 64 cases accepted Non-extracorpoeal circulation sur-gery.And make a comparative study of the clinical data of two kinds of coronary bypass operation. Results Com-pared with the Extacorpeal circulation group,the operation time,bypass vessel numb,the Thoracic Drainage were no statistic difference in Non-extracorpoealcirculation(P>0.05),The amount of transfused blood;Mechanical ven-tilation time,Hospitalized time in ICU;Postoperative complications;Total hospitalization time were Significantly lower than Extacorpeal circulation group,the difference was statistically significant(P < 0.05). Conclusions As the development of technology and the maturity of the operator′s experience,Off-pump coronary artery bypass graft-ing is safe and effective in elderly patients,which could be further promoted in clinical practice.
ABSTRACT
There were 3,129 consecutive patients who underwent CABG by only one operator at Kishiwada Tokushukai Hospital between January 1991 and December 2010. These patients included 236 patients requiring chronic renal hemodialysis at the time of operation. They consisted of 181 men and 55 women, with an average age of 64.1±9.7 years. The mean duration of hemodialysis was 10.1±20.4 years. Diabetic nephropathy (133 cases, 56.4%) was the most common disease leading to required for hemodialysis. The operative mortality and the hospital mortality were 3.4% and 6.4% respectively. The 1-year survival rate, the 3-year survival rate, the 5 year survival rate and the 10-year survival rate were 72.4%, 48.3%, 32.4% and 14.3%. Multivariate logistic analysis revealed that only peripheral artery disease (PAD) was a significant risk factor for mortality (<i>p</i><0.05). The infectious diseases were the most common cause of long term death (24.1%). The mortality rates of CABG in patients with dialysis-dependent renal failure are still higher than those for non-hemodialysis patients. Our data suggest that PAD is a great risk factor for mortality following CABG in hemodialysis patients.