Off-pump compared to minimal extracorporeal circulation surgery in coronary artery bypass grafting.

Reuthebuch, Oliver; Koechlin, Luca; Gahl, Brigitta; Matt, Peter; Schurr, Ulrich; Grapow, Martin; Eckstein, Friedrich (2014). Off-pump compared to minimal extracorporeal circulation surgery in coronary artery bypass grafting. Swiss medical weekly, 144(w13978), w13978. EMH Schweizerischer Ärzteverlag 10.4414/smw.2014.13978

[img]
Preview
Text
smw-2014-13978.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (742kB) | Preview

OBJECTIVE Coronary artery bypass grafting (CABG) using extracorporeal circulation (ECC) is still the gold standard. However, alternative techniques have been developed to avoid ECC and its potential adverse effects. These encompass minimal extracorporeal circulation (MECC) or off-pump coronary artery bypass grafting (OPCAB). However, the prevailing potential benefits when comparing MECC and OPCABG are not yet clearly established. METHODS In this retrospective study we investigated the potential benefits of MECC and OPCABG in 697 patients undergoing CABG. Of these, 555 patients had been operated with MECC and 142 off-pump. The primary endpoint was Troponin T level as an indicator for myocardial damage. RESULTS Study groups were not significantly different in general. However, patients undergoing OPCABG were significantly older (65.01 years ± 9.5 vs. 69.39 years ± 9.5; p value <0.001) with a higher Logistic EuroSCORE I (4.92% ± 6.5 vs. 5.88% ± 6.8; p value = 0.017). Operating off pump significantly reduced the need for intra-operative blood products (0.7% vs. 8.6%; p-value <0.001) and the length of stay in the intensive care unit (ICU) (2.04 days ± 2.63 vs. 2.76 days ± 2.79; p value <0.001). Regarding other blood values a significant difference could not be found in the adjusted calculations. The combined secondary endpoint, major cardiac or cerebrovascular events (MACCE), was equal in both groups as well. CONCLUSIONS Coronary artery bypass grafting using MECC or OPCABG are two comparable techniques with advantages for OPCABG regarding the reduced need for intra-operative blood products and shorter length of stay in the ICU. However serological values and combined endpoint MACCE did not differ significantly in both groups.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Gahl, Brigitta

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Sara Baumberger

Date Deposited:

27 Feb 2015 11:52

Last Modified:

26 Jun 2016 01:58

Publisher DOI:

10.4414/smw.2014.13978

PubMed ID:

24921922

BORIS DOI:

10.7892/boris.63830

URI:

https://boris.unibe.ch/id/eprint/63830

Actions (login required)

Edit item Edit item
Provide Feedback