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On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes

OBJECTIVE: On pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left vent...

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Autores principales: Dayan, Victor, Paganini, Juan Jose, Marichal, Alvaro, Brusich, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985846/
https://www.ncbi.nlm.nih.gov/pubmed/29898149
http://dx.doi.org/10.21470/1678-9741-2017-0161
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author Dayan, Victor
Paganini, Juan Jose
Marichal, Alvaro
Brusich, Daniel
author_facet Dayan, Victor
Paganini, Juan Jose
Marichal, Alvaro
Brusich, Daniel
author_sort Dayan, Victor
collection PubMed
description OBJECTIVE: On pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left ventricular function. Our aim was to study the postoperative results using both techniques in this group of patients. METHODS: One thousand one hundred and forty-five patients with stable angina underwent on-pump isolated CABG in Uruguay from 2011 to 2015. Patients were grouped into beating/non-beating CABG. Operative mortality and long-term survival were evaluated as primary outcome. Logistic regression analysis was performed to define the predictive role of aortic cross clamp (AXC) on prolonged inotropic support, ventilator support and intraoperative glycemia. RESULTS: Among the included patients, 988 underwent aortic cross clamp. No differences were found in operative mortality, stroke and long-term survival among both groups. Patients without AXC showed higher intraoperative values of glycemia and higher incidence of postoperative prolonged mechanical ventilator support (7.6% vs. 2.4%; P=0.001). The need for prolonged inotropic support was lower in this group of patients (27.4% vs. 49.5%; P<0.001). CONCLUSION: On-pump beating CABG has similar operative mortality and long-term survival compared with conventional AXC. Higher intraoperative glycemia and higher incidence for prolonged mechanical ventilator is associated with on-pump beating CABG. On the contrary, higher incidence for prolonged inotropic support is associated with AXC. Taking these factors into consideration, both techniques are safe and allow the surgeon to choose the most comfortable option.
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spelling pubmed-59858462018-06-06 On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes Dayan, Victor Paganini, Juan Jose Marichal, Alvaro Brusich, Daniel Braz J Cardiovasc Surg Original Article OBJECTIVE: On pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left ventricular function. Our aim was to study the postoperative results using both techniques in this group of patients. METHODS: One thousand one hundred and forty-five patients with stable angina underwent on-pump isolated CABG in Uruguay from 2011 to 2015. Patients were grouped into beating/non-beating CABG. Operative mortality and long-term survival were evaluated as primary outcome. Logistic regression analysis was performed to define the predictive role of aortic cross clamp (AXC) on prolonged inotropic support, ventilator support and intraoperative glycemia. RESULTS: Among the included patients, 988 underwent aortic cross clamp. No differences were found in operative mortality, stroke and long-term survival among both groups. Patients without AXC showed higher intraoperative values of glycemia and higher incidence of postoperative prolonged mechanical ventilator support (7.6% vs. 2.4%; P=0.001). The need for prolonged inotropic support was lower in this group of patients (27.4% vs. 49.5%; P<0.001). CONCLUSION: On-pump beating CABG has similar operative mortality and long-term survival compared with conventional AXC. Higher intraoperative glycemia and higher incidence for prolonged mechanical ventilator is associated with on-pump beating CABG. On the contrary, higher incidence for prolonged inotropic support is associated with AXC. Taking these factors into consideration, both techniques are safe and allow the surgeon to choose the most comfortable option. Sociedade Brasileira de Cirurgia Cardiovascular 2018 /pmc/articles/PMC5985846/ /pubmed/29898149 http://dx.doi.org/10.21470/1678-9741-2017-0161 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Dayan, Victor
Paganini, Juan Jose
Marichal, Alvaro
Brusich, Daniel
On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title_full On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title_fullStr On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title_full_unstemmed On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title_short On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes
title_sort on-pump beating/non-beating cabg in stable angina have similar outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985846/
https://www.ncbi.nlm.nih.gov/pubmed/29898149
http://dx.doi.org/10.21470/1678-9741-2017-0161
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