Off-pump coronary artery bypass is a safe option in patients presenting as emergency

Eliana Cecilia Martinez Valencia, Maximilian Y. Emmert, George N. Thomas, Lorenz S. Emmert, Chuen Neng Lee, Theo Kofidis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery. Materials and Methods: Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed. Results: Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4% vs 14.7%, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1% vs 35.3%, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9% vs 8.8%, P = 0.51) and required less inotropic support (66.2% vs 88.2%, P = 0.002), bloodtransfusions (23% vs 86.8%, P <0.0001), and atrial- (17.6% vs 35.3%, P = 0.02) or ventricular-pacing (17.6% vs 41.2%, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5% vs 94.1%, P = 0.004). Conclusion: OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.

Original languageEnglish (US)
Pages (from-to)607-612
Number of pages6
JournalAnnals of the Academy of Medicine Singapore
Volume39
Issue number8
StatePublished - Aug 2010
Externally publishedYes

Fingerprint

Off-Pump Coronary Artery Bypass
Emergencies
Ventilation
Demography
Coronary Artery Bypass
Renal Insufficiency
Stroke
Safety
Lung
Mortality

Keywords

  • Cardiac surgery
  • Coronary artery disease
  • Off-pump coronary-artery bypass

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Martinez Valencia, E. C., Emmert, M. Y., Thomas, G. N., Emmert, L. S., Lee, C. N., & Kofidis, T. (2010). Off-pump coronary artery bypass is a safe option in patients presenting as emergency. Annals of the Academy of Medicine Singapore, 39(8), 607-612.

Off-pump coronary artery bypass is a safe option in patients presenting as emergency. / Martinez Valencia, Eliana Cecilia; Emmert, Maximilian Y.; Thomas, George N.; Emmert, Lorenz S.; Lee, Chuen Neng; Kofidis, Theo.

In: Annals of the Academy of Medicine Singapore, Vol. 39, No. 8, 08.2010, p. 607-612.

Research output: Contribution to journalArticle

Martinez Valencia, EC, Emmert, MY, Thomas, GN, Emmert, LS, Lee, CN & Kofidis, T 2010, 'Off-pump coronary artery bypass is a safe option in patients presenting as emergency', Annals of the Academy of Medicine Singapore, vol. 39, no. 8, pp. 607-612.
Martinez Valencia, Eliana Cecilia ; Emmert, Maximilian Y. ; Thomas, George N. ; Emmert, Lorenz S. ; Lee, Chuen Neng ; Kofidis, Theo. / Off-pump coronary artery bypass is a safe option in patients presenting as emergency. In: Annals of the Academy of Medicine Singapore. 2010 ; Vol. 39, No. 8. pp. 607-612.
@article{66ab7c7b37c84451b34c4f2ef5eb638c,
title = "Off-pump coronary artery bypass is a safe option in patients presenting as emergency",
abstract = "Introduction: The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery. Materials and Methods: Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed. Results: Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4{\%} vs 14.7{\%}, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1{\%} vs 35.3{\%}, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9{\%} vs 8.8{\%}, P = 0.51) and required less inotropic support (66.2{\%} vs 88.2{\%}, P = 0.002), bloodtransfusions (23{\%} vs 86.8{\%}, P <0.0001), and atrial- (17.6{\%} vs 35.3{\%}, P = 0.02) or ventricular-pacing (17.6{\%} vs 41.2{\%}, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5{\%} vs 94.1{\%}, P = 0.004). Conclusion: OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.",
keywords = "Cardiac surgery, Coronary artery disease, Off-pump coronary-artery bypass",
author = "{Martinez Valencia}, {Eliana Cecilia} and Emmert, {Maximilian Y.} and Thomas, {George N.} and Emmert, {Lorenz S.} and Lee, {Chuen Neng} and Theo Kofidis",
year = "2010",
month = "8",
language = "English (US)",
volume = "39",
pages = "607--612",
journal = "Annals of the Academy of Medicine, Singapore",
issn = "0304-4602",
publisher = "Academy of Medicine Singapore",
number = "8",

}

TY - JOUR

T1 - Off-pump coronary artery bypass is a safe option in patients presenting as emergency

AU - Martinez Valencia, Eliana Cecilia

AU - Emmert, Maximilian Y.

AU - Thomas, George N.

AU - Emmert, Lorenz S.

AU - Lee, Chuen Neng

AU - Kofidis, Theo

PY - 2010/8

Y1 - 2010/8

N2 - Introduction: The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery. Materials and Methods: Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed. Results: Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4% vs 14.7%, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1% vs 35.3%, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9% vs 8.8%, P = 0.51) and required less inotropic support (66.2% vs 88.2%, P = 0.002), bloodtransfusions (23% vs 86.8%, P <0.0001), and atrial- (17.6% vs 35.3%, P = 0.02) or ventricular-pacing (17.6% vs 41.2%, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5% vs 94.1%, P = 0.004). Conclusion: OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.

AB - Introduction: The applicability of off-pump coronary-artery bypass (OPCAB) in patients who present as emergency remains controversial. Herein, we explore the efficacy and safety of OPCAB in patients who were indicated for emergency surgery. Materials and Methods: Between 2002 and 2007, a total of 282 patients underwent OPCAB, of which 68 were presented as emergency. This cohort (group A) was compared to 68 patients who had traditional on-pump coronary artery bypass grafting (CABG, group B) under emergency indications during the same period of time. Baseline demographics, intraoperative data and postoperative outcomes were analysed. Results: Preoperative demographics were comparable in both groups. Mortality during the first 30 days was comparable in both groups and no stroke occurred in the whole series. Patients in group A had significantly less pulmonary complications (4.4% vs 14.7%, P = 0.04), less ventilation time (30.3 ± 33.6 hours vs 41.5 ± 55.4 hours, P = 0.18) and were less likely to have prolonged ventilation, (19.1% vs 35.3%, P = 0.03). Similarly, OPCAB patients had less postoperative renal-failure/dysfunction (5.9% vs 8.8%, P = 0.51) and required less inotropic support (66.2% vs 88.2%, P = 0.002), bloodtransfusions (23% vs 86.8%, P <0.0001), and atrial- (17.6% vs 35.3%, P = 0.02) or ventricular-pacing (17.6% vs 41.2%, P = 0.002). Although the number of diseased vessels was comparable in both groups, patients in group A received less distal anastomoses. (2.78 ± 1.19 vs 3.41 ± 0.89, P = 0.002). Similarly, complete revascularisation was achieved less frequently in group A (76.5% vs 94.1%, P = 0.004). Conclusion: OPCAB strategy is a safe and efficient in emergency patients with reasonable good short-term postoperative outcomes.

KW - Cardiac surgery

KW - Coronary artery disease

KW - Off-pump coronary-artery bypass

UR - http://www.scopus.com/inward/record.url?scp=77957372924&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957372924&partnerID=8YFLogxK

M3 - Article

VL - 39

SP - 607

EP - 612

JO - Annals of the Academy of Medicine, Singapore

JF - Annals of the Academy of Medicine, Singapore

SN - 0304-4602

IS - 8

ER -