Elimination of cardiopulmonary bypass: A prime goal in reoperative coronary artery bypass surgery

Jacob Bergsland, Saira Hasnain, Thomas Z. Lajos, Tomas Salerno

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: The purpose of this study was to evaluate morbidity and mortality in reoperative coronary artery bypass surgery using the New York State database. Methods: Patients undergoing reoperative coronary artery bypass between January-1995 and December 1996 were included. Patients were operated using cardiopulmonary bypass (CPB group, n = 184) or without cardiopulmonary bypass (non-CPB group, n = 105) by surgeon preference. Groups were compared for preoperative risk factors, postoperative mortality and major complications. Results: Crude mortality was lower in the non-CPB group, despite a higher expected mortality, resulting in a risk-adjusted mortality of 1.3% versus 2.7% for the CPB group (NS). Of non-CPB patients, 91.4% were without complications, while only 72.1% of CPB patients (P < 0.0001) were complication-free. Major complications were significantly reduced in non-CPB patients compared to CPB patients: stroke 0% versus 3.8% (P < 0.04), cardiovascular complications 4.8% versus 15.8% (P < 0.005), other major complications 1.9% versus 10.4% (P < 0.007). Postoperative IABP support was needed in 1.9% of the non-CPB group patients and in 14.2% of the CPB group (P < 0.0007). Conclusions: The main object of reoperative CABG is to relieve symptoms, since the survival benefit of the procedure has not been demonstrated. Performance of reoperative coronary artery bypass surgery without cardiopulmonary bypass significantly reduces morbidity. We conclude that cardiopulmonary bypass should be avoided whenever possible in reoperative coronary bypass surgery.

Original languageEnglish
Pages (from-to)59-63
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume14
Issue number1
DOIs
StatePublished - Jul 1 1998
Externally publishedYes

Fingerprint

Cardiopulmonary Bypass
Coronary Artery Bypass
Mortality
Morbidity
Stroke
Databases
Survival

Keywords

  • Cardiopulmonary bypass
  • Complication
  • Coronary artery bypass
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Elimination of cardiopulmonary bypass : A prime goal in reoperative coronary artery bypass surgery. / Bergsland, Jacob; Hasnain, Saira; Lajos, Thomas Z.; Salerno, Tomas.

In: European Journal of Cardio-thoracic Surgery, Vol. 14, No. 1, 01.07.1998, p. 59-63.

Research output: Contribution to journalArticle

@article{3f13860c32f44864a79a1ea32f8840c6,
title = "Elimination of cardiopulmonary bypass: A prime goal in reoperative coronary artery bypass surgery",
abstract = "Objective: The purpose of this study was to evaluate morbidity and mortality in reoperative coronary artery bypass surgery using the New York State database. Methods: Patients undergoing reoperative coronary artery bypass between January-1995 and December 1996 were included. Patients were operated using cardiopulmonary bypass (CPB group, n = 184) or without cardiopulmonary bypass (non-CPB group, n = 105) by surgeon preference. Groups were compared for preoperative risk factors, postoperative mortality and major complications. Results: Crude mortality was lower in the non-CPB group, despite a higher expected mortality, resulting in a risk-adjusted mortality of 1.3{\%} versus 2.7{\%} for the CPB group (NS). Of non-CPB patients, 91.4{\%} were without complications, while only 72.1{\%} of CPB patients (P < 0.0001) were complication-free. Major complications were significantly reduced in non-CPB patients compared to CPB patients: stroke 0{\%} versus 3.8{\%} (P < 0.04), cardiovascular complications 4.8{\%} versus 15.8{\%} (P < 0.005), other major complications 1.9{\%} versus 10.4{\%} (P < 0.007). Postoperative IABP support was needed in 1.9{\%} of the non-CPB group patients and in 14.2{\%} of the CPB group (P < 0.0007). Conclusions: The main object of reoperative CABG is to relieve symptoms, since the survival benefit of the procedure has not been demonstrated. Performance of reoperative coronary artery bypass surgery without cardiopulmonary bypass significantly reduces morbidity. We conclude that cardiopulmonary bypass should be avoided whenever possible in reoperative coronary bypass surgery.",
keywords = "Cardiopulmonary bypass, Complication, Coronary artery bypass, Mortality",
author = "Jacob Bergsland and Saira Hasnain and Lajos, {Thomas Z.} and Tomas Salerno",
year = "1998",
month = "7",
day = "1",
doi = "10.1016/S1010-7940(98)00138-9",
language = "English",
volume = "14",
pages = "59--63",
journal = "European Journal of Cardio-thoracic Surgery",
issn = "1010-7940",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Elimination of cardiopulmonary bypass

T2 - A prime goal in reoperative coronary artery bypass surgery

AU - Bergsland, Jacob

AU - Hasnain, Saira

AU - Lajos, Thomas Z.

AU - Salerno, Tomas

PY - 1998/7/1

Y1 - 1998/7/1

N2 - Objective: The purpose of this study was to evaluate morbidity and mortality in reoperative coronary artery bypass surgery using the New York State database. Methods: Patients undergoing reoperative coronary artery bypass between January-1995 and December 1996 were included. Patients were operated using cardiopulmonary bypass (CPB group, n = 184) or without cardiopulmonary bypass (non-CPB group, n = 105) by surgeon preference. Groups were compared for preoperative risk factors, postoperative mortality and major complications. Results: Crude mortality was lower in the non-CPB group, despite a higher expected mortality, resulting in a risk-adjusted mortality of 1.3% versus 2.7% for the CPB group (NS). Of non-CPB patients, 91.4% were without complications, while only 72.1% of CPB patients (P < 0.0001) were complication-free. Major complications were significantly reduced in non-CPB patients compared to CPB patients: stroke 0% versus 3.8% (P < 0.04), cardiovascular complications 4.8% versus 15.8% (P < 0.005), other major complications 1.9% versus 10.4% (P < 0.007). Postoperative IABP support was needed in 1.9% of the non-CPB group patients and in 14.2% of the CPB group (P < 0.0007). Conclusions: The main object of reoperative CABG is to relieve symptoms, since the survival benefit of the procedure has not been demonstrated. Performance of reoperative coronary artery bypass surgery without cardiopulmonary bypass significantly reduces morbidity. We conclude that cardiopulmonary bypass should be avoided whenever possible in reoperative coronary bypass surgery.

AB - Objective: The purpose of this study was to evaluate morbidity and mortality in reoperative coronary artery bypass surgery using the New York State database. Methods: Patients undergoing reoperative coronary artery bypass between January-1995 and December 1996 were included. Patients were operated using cardiopulmonary bypass (CPB group, n = 184) or without cardiopulmonary bypass (non-CPB group, n = 105) by surgeon preference. Groups were compared for preoperative risk factors, postoperative mortality and major complications. Results: Crude mortality was lower in the non-CPB group, despite a higher expected mortality, resulting in a risk-adjusted mortality of 1.3% versus 2.7% for the CPB group (NS). Of non-CPB patients, 91.4% were without complications, while only 72.1% of CPB patients (P < 0.0001) were complication-free. Major complications were significantly reduced in non-CPB patients compared to CPB patients: stroke 0% versus 3.8% (P < 0.04), cardiovascular complications 4.8% versus 15.8% (P < 0.005), other major complications 1.9% versus 10.4% (P < 0.007). Postoperative IABP support was needed in 1.9% of the non-CPB group patients and in 14.2% of the CPB group (P < 0.0007). Conclusions: The main object of reoperative CABG is to relieve symptoms, since the survival benefit of the procedure has not been demonstrated. Performance of reoperative coronary artery bypass surgery without cardiopulmonary bypass significantly reduces morbidity. We conclude that cardiopulmonary bypass should be avoided whenever possible in reoperative coronary bypass surgery.

KW - Cardiopulmonary bypass

KW - Complication

KW - Coronary artery bypass

KW - Mortality

UR - http://www.scopus.com/inward/record.url?scp=0031829354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031829354&partnerID=8YFLogxK

U2 - 10.1016/S1010-7940(98)00138-9

DO - 10.1016/S1010-7940(98)00138-9

M3 - Article

C2 - 9726616

AN - SCOPUS:0031829354

VL - 14

SP - 59

EP - 63

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 1

ER -