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Thrombotic complications in beating heart operations

R Cartier1, D Robitaille

  • 1Department of Cardiac Surgery, Montreal Heart Institute, 5000 Belanger St. East, Montreal, Quebec H1T 1C8, Canada. RC2910@aol.com

The Journal of Thoracic and Cardiovascular Surgery
|April 28, 2001
PubMed

Insights

Off-pump coronary artery bypass operations show similar thromboembolic complication rates to traditional cardiopulmonary bypass. Despite low prevalence, these events warrant reconsidering prophylactic measures for cardiac surgery patients.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Off-pump coronary artery bypass (CAB) surgery is increasingly popular, avoiding cardiopulmonary bypass (CPB).
  • Reduced anticoagulation is common in off-pump CAB to minimize bleeding and transfusion needs.
  • Historically, CAB with CPB patients were not considered high risk for thromboembolic events, negating prophylaxis.

Purpose of the Study:

  • To evaluate the incidence of thromboembolic complications in off-pump coronary artery bypass (CAB) operations.
  • To compare these complication rates with those in patients undergoing CAB with cardiopulmonary bypass (CPB).

Main Methods:

  • Retrospective review of 500 off-pump CAB operations.
  • Comparison with a cohort of 1476 patients who underwent CAB with CPB.
  • Focus on clinically manifested thromboembolic complications.

Main Results:

  • Thromboembolic complications occurred in 1% of off-pump CAB patients, with one death.
  • In the CPB group, 0.5% experienced thromboembolic complications, specifically stroke.
  • The observed difference in complication rates between the two groups was not statistically significant.

Conclusions:

  • Thromboembolic complications are comparable between off-pump CAB and CAB with CPB.
  • The low but significant morbidity associated with these events necessitates re-evaluation of prophylactic strategies.
Abstract

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