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Isolated myocardial revascularization with intermittent aortic cross-clamping: experience with 800 cases
Lucia Raco1, Edward Mills, Russell J W Millner
1Department of Cardiothoracic Surgery, Blackpool Victoria Hospital, United Kingdom. luciaduke@netscapeonline.co.uk
Background:
We investigated the clinical outcome of elective and nonelective myocardial revascularization performed with intermittent aortic cross-clamping.
Methods:
Prospective data on 800 consecutive patients (from May 1996 to July 2000), who underwent isolated myocardial revascularization with intermittent aortic cross-clamping, were analyzed. A subgroup analysis was performed on the elective (n = 520), urgent (n = 226), and emergency (n = 54) procedures.
Results:
The elective group of patients had a mean age of 61.5 +/- 9.46 years, mean Parsonnet score of 5.23 +/- 5.1, and mean number of distal anastomoses of 3.22 +/- 1.04. The hospital mortality was 0.57%. The urgent group of patients had a mean age of 63.06 +/- 10.43 years, mean Parsonnet score of 6.73 +/- 6.22, and mean number of distal anastomoses of 3.21 +/- 1.04. The hospital mortality was 3.09%. The emergency group of patients had a mean age of 63.75 +/- 9.63 years, mean Parsonnet score of 11.24 +/- 11, and mean number of distal anastomoses of 2.87 +/- 0.86. Hospital mortality was 5.55%. Postoperative hospital stay was 7.11 +/- 5.47 days for the elective group, 7.59 +/- 5.07 days for the urgent group, and 7.40 +/- 4.01 days for the emergency group.
Conclusions:
Intermittent aortic cross-clamping is a safe technique both in elective and nonelective patients. The mortality and morbidity in the three subgroups analyzed reflects patients' distribution against Parsonnet score.