Conversion after off-pump coronary artery bypass grafting: the CORONARY trial experience
Eur J Cardiothorac Surg
; 51(3): 539-546, 2017. graf, tab
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1062623
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
OBJECTIVES:
Emergent and late conversions form OFF-to-ON pump coronary artery bypass grafting (CABG) have been associated with worse outcomes, however, it remains unclear as to which risk factors are associated with conversion and how to prevent them.METHODS:
Among 4718 patients who randomly underwent off- or on-pump CABG, the incidence of off-pump to on-pump cross-over, or 'OFF-to-ON conversion', was 7.9% (186/2356). The primary outcome was a composite of death, stroke, myocardial infarction, or new renal failure requiring dialysis. We assessed the risk factors and outcomes of converted patients.RESULTS:
Emergent OFF-to-ON conversions, defined as conversions for hypotension or ischaemia, were required for 3.2% of patients ( n = 75), while most elective conversions were due to small or intramuscular coronaries ( n = 83). OFF-to-ON converted patients required increased surgery time, blood transfusions, intensive care unit stay, and presented a higher incidence at 1 year of the composite outcome compared with non-converted off-pump patients (all P < 0.01), especially if the conversion was emergent. Conversely, elective conversions outcomes were no different compared with non-converted off-pump patients ( P = 0.35). Independent predictors of emergent conversions included higher heart rate or chronic atrial fibrillation, urgent surgery, more grafts planned and surgeon experience with off-pump CABG...
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Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Cirurgia Geral
/
Circulação Extracorpórea
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Cuidados Intraoperatórios
/
Revascularização Miocárdica
Tipo de estudo:
Estudo prognóstico
/
Fatores de risco
Idioma:
Inglês
Revista:
Eur J Cardiothorac Surg
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
Department of Cardiothoracic Surgery, India Global Hospitals/IN
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Department of Cardiothoracic Surgery, Institute of Cardiology of Corrientes/AR
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Department of Cardiothoracic Surgery, Mercy Medical Research Institute/US
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Department of Cardiothoracic Surgery, Nanjing First Hospital/CN
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Department of Cardiovascular Surgery, São Francisco Hospital/BR
/
Department of Surgery, Division of Cardiac Surgery McMaster University and Population Health Research Institute/CA
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Department of Surgery, Division of Cardiac Surgery, Centre Hospitalier de l'Université de Montréal and Research Center/CA
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Research Division, Dante Pazzanese Institute of Cardiology/BR