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Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles
BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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King Faisal Specialist Hospital and Research Centre
2014
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074587/ https://www.ncbi.nlm.nih.gov/pubmed/25266182 http://dx.doi.org/10.5144/0256-4947.2014.222 |
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author | Yu, Lei Gu, Tianxiang Shi, Enyi Wang, Chun Fang, Qin Yu, Yang Zhao, Xiaoqi Qian, Cheng |
author_facet | Yu, Lei Gu, Tianxiang Shi, Enyi Wang, Chun Fang, Qin Yu, Yang Zhao, Xiaoqi Qian, Cheng |
author_sort | Yu, Lei |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients with enlarged ventricles remains controversial. This prospective randomized study was designed to characterize comparison of early clinical outcome and mid-term follow-up following ONCAB versus OPCAB in patients with triple-vessel disease and enlarged ventricles. DESIGN AND SETTINGS: Prospective randomized trial of patients treated at The First Affiliated Hospital, China Medical University, over a 3-year period (2007–2010). METHODS: A total of 102 patients with triple-vessel disease and enlarged ventricles (end-diastolic dimension ≥6.0 cm) were randomized to OPCAB or ONCAB between July 2007 and December 2010. The in-hospital outcomes were analyzed. The study included a mid-term follow-up, with a mean follow-up time of 49.40 (12.88 months). RESULTS: No significant differences were recorded in the baseline clinical characteristics of ONCAB and OPCAB groups. A statistical difference was found between the two groups at the time of extubation, intensive care unit stay, hospital stay, blood requirements, incidence of intra-aortic balloon pump support, pulmonary complications, stroke, reoperation for bleeding, and inotropic requirements >24 hours (P<.05). The number of anastomoses performed per patient, the incidence of postoperative ventricular arrhythmia, myocardial infarction, new-onset atrial fibrillation, hemodialysis, infective complications, recurrent angina, and percutaneous reintervention were similar between the 2 groups (P>.05). The left ventricular end-diastolic dimension was significantly smaller at 6 months’ follow-up in the 2 groups than it was before operation (<.05). No differences in hospital mortality and mid-term mortality between OPCAB and ONCAB groups were found. During the follow-up, no patient in either group had undergone repeat coronary artery bypass grafting. CONCLUSION: No differences in early and mid-term mortality were found between OPCAB and ONCAB in patients with triple-vessel disease and enlarged ventricles. However, OPCAB seems to have a beneficial effect on postoperative complications. |
format | Online Article Text |
id | pubmed-6074587 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | King Faisal Specialist Hospital and Research Centre |
record_format | MEDLINE/PubMed |
spelling | pubmed-60745872018-09-21 Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles Yu, Lei Gu, Tianxiang Shi, Enyi Wang, Chun Fang, Qin Yu, Yang Zhao, Xiaoqi Qian, Cheng Ann Saudi Med Original Article BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients with enlarged ventricles remains controversial. This prospective randomized study was designed to characterize comparison of early clinical outcome and mid-term follow-up following ONCAB versus OPCAB in patients with triple-vessel disease and enlarged ventricles. DESIGN AND SETTINGS: Prospective randomized trial of patients treated at The First Affiliated Hospital, China Medical University, over a 3-year period (2007–2010). METHODS: A total of 102 patients with triple-vessel disease and enlarged ventricles (end-diastolic dimension ≥6.0 cm) were randomized to OPCAB or ONCAB between July 2007 and December 2010. The in-hospital outcomes were analyzed. The study included a mid-term follow-up, with a mean follow-up time of 49.40 (12.88 months). RESULTS: No significant differences were recorded in the baseline clinical characteristics of ONCAB and OPCAB groups. A statistical difference was found between the two groups at the time of extubation, intensive care unit stay, hospital stay, blood requirements, incidence of intra-aortic balloon pump support, pulmonary complications, stroke, reoperation for bleeding, and inotropic requirements >24 hours (P<.05). The number of anastomoses performed per patient, the incidence of postoperative ventricular arrhythmia, myocardial infarction, new-onset atrial fibrillation, hemodialysis, infective complications, recurrent angina, and percutaneous reintervention were similar between the 2 groups (P>.05). The left ventricular end-diastolic dimension was significantly smaller at 6 months’ follow-up in the 2 groups than it was before operation (<.05). No differences in hospital mortality and mid-term mortality between OPCAB and ONCAB groups were found. During the follow-up, no patient in either group had undergone repeat coronary artery bypass grafting. CONCLUSION: No differences in early and mid-term mortality were found between OPCAB and ONCAB in patients with triple-vessel disease and enlarged ventricles. However, OPCAB seems to have a beneficial effect on postoperative complications. King Faisal Specialist Hospital and Research Centre 2014 /pmc/articles/PMC6074587/ /pubmed/25266182 http://dx.doi.org/10.5144/0256-4947.2014.222 Text en Copyright © 2014, Annals of Saudi Medicine This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Yu, Lei Gu, Tianxiang Shi, Enyi Wang, Chun Fang, Qin Yu, Yang Zhao, Xiaoqi Qian, Cheng Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title_full | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title_fullStr | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title_full_unstemmed | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title_short | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
title_sort | off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074587/ https://www.ncbi.nlm.nih.gov/pubmed/25266182 http://dx.doi.org/10.5144/0256-4947.2014.222 |
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