Fast-track off-pump coronary artery bypass: single-center experience

Area of Science:

• Cardiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Fast-track cardiac surgery protocols aim to reduce length of stay and improve patient outcomes.
• Coronary artery bypass grafting (CABG) is a common cardiac surgical procedure.
• Identifying factors influencing fast-track success is essential for optimizing patient care.

Purpose of the Study:

• To conduct a retrospective analysis of fast-track CABG at our institution.
• To identify risk factors associated with prolonged hospital stay after fast-track CABG.
• To compare survival statistics with existing literature.

Main Methods:

• Retrospective analysis of 709 patients undergoing fast-track CABG.
• Patients had a mean age of 58.85 years, with 572 males.
• Mean EuroSCORE II was 2.02%; 76% were discharged within 100 hours.

Main Results:

• Prolonged ventilation/reintubation, pulmonary, gastrointestinal, and neurological complications were strong predictors of fast-track failure.
• Other significant risk factors included atrial fibrillation, renal impairment, sternal wound infection, diabetes, preoperative balloon pump use, left ventricular dysfunction, and peripheral arterial disease.
• Cumulative survival at 66 months was 90.2% ± 0.02%.

Conclusions:

• Several factors significantly increase the risk of fast-track failure in CABG patients.
• Smoking cessation can mitigate the impact of chronic obstructive pulmonary disease on fast-track outcomes.
• Survival rates are comparable to those reported in the literature, supporting the efficacy of the protocol.