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Simultaneous off-pump coronary revascularization with pulmonary resection or vascular surgery
Cengiz Köksal1, Sabit Sarikaya, Vural Ozcan
1Sureyyapasa Thoracic and Cardiovascular Disease Hospital, Cardiovascular Surgery Clinic, Maltepe, Istanbul-TURKEY. cengizkoksal@hotmail.com
Middle East Journal of Anaesthesiology
|January 18, 2005
Summary
Off-pump coronary artery bypass grafting (OPCAB) combined with peripheral revascularization or lung resection offers a safe option for high-risk patients. This approach avoids cardiopulmonary bypass, demonstrating no in-hospital mortality in a recent study.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Patients needing coronary artery bypass grafting (CABG) with concurrent vascular disease or lung malignancy are high-risk.
- Management of these complex patients is controversial.
- Cardiopulmonary bypass poses significant risks for these individuals.
Purpose of the Study:
- To evaluate the safety and outcomes of combined off-pump coronary artery bypass grafting (OPCAB) with peripheral artery revascularization or lung resection.
- To assess the feasibility of avoiding cardiopulmonary bypass in high-risk surgical candidates.
Main Methods:
- A retrospective review of 26 patients undergoing simultaneous OPCAB with either peripheral revascularization or lung resection between April 2001 and March 2003.
- Procedures included OPCAB with carotid endarterectomy (n=20), aortobifemoral bypass (n=4), and pneumonectomy (n=2).
Main Results:
- No in-hospital mortality was observed.
- One patient required prolonged ventilatory support post-lung resection.
- Median Intensive Care Unit stay was 1.3 days, and median hospital stay was 5.7 days.
Conclusions:
- Combined OPCAB with peripheral revascularization or lung resection is a viable and safe strategy for high-risk patients.
- This approach effectively mitigates the risks associated with cardiopulmonary bypass in complex surgical cases.