Off or on bypass: what is the safety threshold?
Ann Thorac Surg
; 68(4): 1486-9, 1999 Oct.
Article
em En
| MEDLINE
| ID: mdl-10543550
ABSTRACT
BACKGROUND:
To identify the technical profile of the patients operated on without cardiopulmonary bypass (CPB) and the benefit of the procedure.METHODS:
From May 21, 1997, to December 31, 1998, 785 patients had coronary artery bypass grafting through a median sternotomy (group A 472 without CPB; group B 290 with CPB; group C 23 converted). Technical aspects, mortality rate, cerebrovascular accident (CVA) incidence (crude and risk-adjusted), and incidence of major complications were recorded.RESULTS:
Patients without CPB had mainly one to three grafts and one- or two-vessel disease. Multiple arterial grafting was not a limit, whereas sequential grafting was. Group A had lower complications rates, shorter intensive care unit and postoperative in hospital stays, and lower transfusion rates. Mortality rates and CVA incidence (crude and risk-adjusted) were similar in both groups and in each subgroup considered. In group A, a lower complications rate was present in some patients (aged greater than 70 years, female, with unstable angina). Group C showed higher mortality and complications rates. Failure of revascularization showed no difference between groups.CONCLUSIONS:
Primary endpoints are not affected by the surgical strategy, whereas some of the secondary endpoints are. However, patients in group A experienced fewer complications. Both techniques can give satisfying results and must be applied according to the surgeon's preference.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Ponte Cardiopulmonar
/
Ponte de Artéria Coronária
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
1999
Tipo de documento:
Article