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[Coronary artery bypass without extra corporeal circulation]

Y Moshkovitz1, A Lusky, R Mor

  • 1Dept. of Cardiac Surgery, Chaim Sheba Medical Center, Tel Hashomer.

Harefuah
|August 1, 1995
PubMed
Summary
This summary is machine-generated.

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Coronary artery bypass grafting without extracorporeal circulation offers low operative mortality but may increase angina return. It is best for high-risk patients, avoiding emergency operations and calcified aortas.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Context:

  • Coronary artery bypass grafting (CABG) is a common procedure to treat coronary artery disease.
  • Extracorporeal circulation (ECC) is traditionally used during CABG but carries risks.
  • Off-pump CABG (OPCAB) aims to reduce ECC-related complications.

Purpose:

  • To evaluate the outcomes and identify risk factors associated with CABG performed without extracorporeal circulation (off-pump CABG).
  • To assess the early and late results of off-pump CABG in a large patient cohort.
  • To determine predictors of operative mortality and unfavorable outcomes in off-pump CABG.

Summary:

  • 240 patients underwent off-pump CABG with a mean of 1.9 grafts per patient.

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  • Operative mortality was 2.9%, with higher risks for emergency operations (10%) and calcified aorta (12%).
  • 1-year survival was 92%, with 80% uneventful outcomes; however, 7.5% experienced early angina recurrence. Independent predictors of unfavorable events included calcified aorta, nonuse of the internal mammary artery (IMA), reoperation, and diabetes mellitus.
  • Impact:

    • Off-pump CABG can be performed with acceptable operative mortality, making it a viable option for selected patients.
    • The procedure may be associated with an increased risk of early angina return, necessitating careful patient selection.
    • Emergency operations and calcified aorta are significant risk factors for early mortality in off-pump CABG.