RT Journal Article
SR Electronic
T1 Off pump coronary artery bypass surgery for significant left ventricular dysfunction: safety, feasibility, and trends in methodology over time—an early experience
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 499
OP 502
DO 10.1136/hrt.2005.062778
VO 92
IS 4
A1 E Sharoni
A1 H K Song
A1 R J Peterson
A1 R A Guyton
A1 J D Puskas
YR 2006
UL http://heart.bmj.com/content/92/4/499.abstract
AB Objective: To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design: Retrospective study. Setting: Tertiary care university affiliated referral centre. Participants: 353 consecutive patients with preoperative left ventricular ejection fraction ⩽ 35% who underwent coronary artery bypass over a three year period. Main outcome measures: Postoperative morbidity and mortality. Methods: 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre- and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results: Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13% to 67%), without any impact on morbidity or mortality. Conclusions: OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach.