Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore

George Naveen Thomas, Eliana Cecilia Martinez Valencia, Felix Woitek, Maximilian Y. Emmert, Hisashi Sakaguchi, Sonja Muecke, Chuen Neng Lee, Theo Kofidis

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Summary Left main disease (LMD) and associated cardiac risk factors are often perceived as a limiting factor for the outcome of off-pump coronary artery bypass (OPCAB) grafting. In this study, we assess whether the outcome of OPCAB surgery is affected in such patients. Methods: We retrospectively compared perioperative parameters in 66 OPCAB patients (group A) with LMD and 216 OPCAB patients without (group B) LMD. The patients were operated in the time frame between 2002 and 2007. LMD was defined as a stenosis >50%. Results: Patients in group A had a higher EuroSCORE (logistic: 3.7 ± 0.1 vs 6.3 ± 0.3, p = 0.027), increased coronary artery disease (CAD) family history (p = 0.015) and cerebrovascular accidents (p = 0.027), increased history of congestive heart failure (p = 0.013), more urgent surgery (p = 0.008), previous percutaneous transluminal coronary angioplasties (PTCAs) (p = 0.05) and previous stent implantation (p = 0.023). An intra-aortic balloon pump (IABP) was inserted more frequently in the LMD group preoperatively (p = 0.004). There were two conversions to on-pump during OPCAB surgery. There were no differences in the postoperative outcomes in the LMD group A versus group B, such as cardiac-related events, neurological deficits, cardiac enzyme course, arrhythmias, blood loss, infections and renal failure. Conclusions: The presence of LMD and higher EuroSCORE does not yield adverse outcomes in OPCAB patients.

Original languageEnglish (US)
Pages (from-to)616-620
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume36
Issue number4
DOIs
StatePublished - Oct 2009
Externally publishedYes

Fingerprint

Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Coronary Balloon Angioplasty
Stents
Renal Insufficiency
Cardiac Arrhythmias
Coronary Artery Disease
Heart Diseases
Pathologic Constriction
Heart Failure
Stroke
Enzymes
Infection

Keywords

  • Coronary artery bypass grafting (CABG)
  • Off-pump

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore. / Thomas, George Naveen; Martinez Valencia, Eliana Cecilia; Woitek, Felix; Emmert, Maximilian Y.; Sakaguchi, Hisashi; Muecke, Sonja; Lee, Chuen Neng; Kofidis, Theo.

In: European Journal of Cardio-thoracic Surgery, Vol. 36, No. 4, 10.2009, p. 616-620.

Research output: Contribution to journalArticle

Thomas, George Naveen ; Martinez Valencia, Eliana Cecilia ; Woitek, Felix ; Emmert, Maximilian Y. ; Sakaguchi, Hisashi ; Muecke, Sonja ; Lee, Chuen Neng ; Kofidis, Theo. / Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore. In: European Journal of Cardio-thoracic Surgery. 2009 ; Vol. 36, No. 4. pp. 616-620.
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AU - Thomas, George Naveen

AU - Martinez Valencia, Eliana Cecilia

AU - Woitek, Felix

AU - Emmert, Maximilian Y.

AU - Sakaguchi, Hisashi

AU - Muecke, Sonja

AU - Lee, Chuen Neng

AU - Kofidis, Theo

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N2 - Background: Summary Left main disease (LMD) and associated cardiac risk factors are often perceived as a limiting factor for the outcome of off-pump coronary artery bypass (OPCAB) grafting. In this study, we assess whether the outcome of OPCAB surgery is affected in such patients. Methods: We retrospectively compared perioperative parameters in 66 OPCAB patients (group A) with LMD and 216 OPCAB patients without (group B) LMD. The patients were operated in the time frame between 2002 and 2007. LMD was defined as a stenosis >50%. Results: Patients in group A had a higher EuroSCORE (logistic: 3.7 ± 0.1 vs 6.3 ± 0.3, p = 0.027), increased coronary artery disease (CAD) family history (p = 0.015) and cerebrovascular accidents (p = 0.027), increased history of congestive heart failure (p = 0.013), more urgent surgery (p = 0.008), previous percutaneous transluminal coronary angioplasties (PTCAs) (p = 0.05) and previous stent implantation (p = 0.023). An intra-aortic balloon pump (IABP) was inserted more frequently in the LMD group preoperatively (p = 0.004). There were two conversions to on-pump during OPCAB surgery. There were no differences in the postoperative outcomes in the LMD group A versus group B, such as cardiac-related events, neurological deficits, cardiac enzyme course, arrhythmias, blood loss, infections and renal failure. Conclusions: The presence of LMD and higher EuroSCORE does not yield adverse outcomes in OPCAB patients.

AB - Background: Summary Left main disease (LMD) and associated cardiac risk factors are often perceived as a limiting factor for the outcome of off-pump coronary artery bypass (OPCAB) grafting. In this study, we assess whether the outcome of OPCAB surgery is affected in such patients. Methods: We retrospectively compared perioperative parameters in 66 OPCAB patients (group A) with LMD and 216 OPCAB patients without (group B) LMD. The patients were operated in the time frame between 2002 and 2007. LMD was defined as a stenosis >50%. Results: Patients in group A had a higher EuroSCORE (logistic: 3.7 ± 0.1 vs 6.3 ± 0.3, p = 0.027), increased coronary artery disease (CAD) family history (p = 0.015) and cerebrovascular accidents (p = 0.027), increased history of congestive heart failure (p = 0.013), more urgent surgery (p = 0.008), previous percutaneous transluminal coronary angioplasties (PTCAs) (p = 0.05) and previous stent implantation (p = 0.023). An intra-aortic balloon pump (IABP) was inserted more frequently in the LMD group preoperatively (p = 0.004). There were two conversions to on-pump during OPCAB surgery. There were no differences in the postoperative outcomes in the LMD group A versus group B, such as cardiac-related events, neurological deficits, cardiac enzyme course, arrhythmias, blood loss, infections and renal failure. Conclusions: The presence of LMD and higher EuroSCORE does not yield adverse outcomes in OPCAB patients.

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