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Published on: September 15, 2023
[Effects of on-pump beating-heart coronary artery bypass grafting for left-main patients]
Xiao-qiang Quan1, Zhao-yun Cheng1, Jun-jie Sun1
1Department of Cardiac Surgery, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Insights
On-pump beating-heart coronary artery bypass grafting offers a feasible, lower-risk surgical option for left-main coronary artery disease patients, demonstrating reduced myocardial damage compared to conventional methods.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Procedures
Background:
- Left-main coronary artery disease poses significant risks.
- Conventional coronary artery bypass grafting (CCABG) is a standard treatment.
- On-pump beating-heart coronary artery bypass grafting (OnP-BH CABG) is an alternative approach.
Purpose of the Study:
- To evaluate the clinical value of OnP-BH CABG in left-main patients.
- To compare OnP-BH CABG outcomes with CCABG.
- To assess myocardial damage associated with both procedures.
Main Methods:
- Retrospective analysis of clinical data from 114 patients (66 OnP-BH CABG, 48 CCABG).
- Data collected between January 2009 and January 2012.
- Comparison of cardiopulmonary bypass time, ventilation duration, ICU stay, and cardiac troponin I levels.
Main Results:
- OnP-BH CABG group showed significantly better clinical outcomes.
- Reduced cardiopulmonary bypass time, ventilation time, and ICU stay in the OnP-BH group.
- Lower levels of cardiac troponin I post-procedure in the OnP-BH group, indicating less myocardial damage.
Conclusions:
- OnP-BH CABG is a feasible and safe surgical option for left-main coronary artery disease.
- This technique is associated with lower surgical risk and reduced myocardial injury.
- OnP-BH CABG presents a promising alternative for selected patient populations.
Objective:
To explore the value of on-pump beating-heart coronary artery bypass grafting (OnP-BH CABG) for left-main patients with coronary heart disease through a comparative study with conventional coronary artery bypass grafting (CCABG).
Methods:
The clinical data were retrospectively analyzed for 66 patients of OnP-BH and 48 control cases undergoing CCABG from January 2009 to January 2012 at Department of Cardiac Surgery, People's Hospital of Zhengzhou University.
Results:
OnP-BH group had a better clinical outcome than CCABG group. There were obvious statistical difference in cardiopulmonary bypass (CPB) time, mean ventilation time, intensive care unit stay and recovery time of plasma cardiac troponin I (OnP-BH group vs CCABG group:(89 ± 25) vs (117 ± 28) min, (15 ± 14) vs (27 ± 19) h, (57 ± 27) vs (79 ± 34) h, (6.2 ± 1.8) vs (7.0 ± 2.4) d, all P < 0.05). The data of preoperative cTnI showed no significant difference between two groups (P > 0.05) .However, after CPB, significant intergroup difference existed in the level of cTnI (µg/L) OnP-BH group vs CCABG group: (0.5 h after CPB: (0.132 ± 0.022) vs (0.265 ± 0.014) , 1 h after CPB: (0.341 ± 0.027) vs (0.572 ± 0.046) , 1 h after operation: (0.641 ± 0.036) vs (0.932 ± 0.047) , 6 h after operation: (1.212 ± 0.765) vs (1.627 ± 0.542) and 24 h after operation: (1.496 ± 0.263) vs (1.734 ± 0.328) , all P < 0.05).
Conclusions:
On-pump beating-heart coronary artery bypass grafting is a feasible surgical approach for left-main patients. And it has a low risk and causes less myocardial damage.
