Tags

Type your tag names separated by a space and hit enter

Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians.
Circulation. 2002 Sep 24; 106(12 Suppl 1):I5-10.Circ

Abstract

BACKGROUND

Off-pump coronary artery bypass surgery (OPCAB) has been revived and has gained popularity, although the exact subsets of patients who might benefit most from this technique are unknown. The aim of this retrospective study was to compare the results of coronary artery bypass grafting surgery (CABG) in octogenarians using cardiopulmonary bypass (CPB) or OPCAB techniques.

METHODS AND RESULTS

Over a 5-year period (1995-1999), 125 patients older than 80 years of age were operated for isolated myocardial revascularization (63 using CPB and 62 with OPCAB). There was no statistically significant difference in preoperative comorbidities between groups or in mean left ventricular ejection fraction (54.5+/-15.3% in the CPB group and 50.9+/-13.5% in the OPCAB group, respectively). The mean number of distal anastomosis per patient was 2.9 in CPB group and 2.6 in OPCAB group (P=ns). The majority of patients in both groups had unstable angina and were operated on an urgent basis. The operative mortality was 15.9% in the CPB group and 4.8% in the OPCAB group (P=0.04). There were 4 postoperative strokes (6.3%) in the CPB group and none (0%) in the OPCAB group (P=0.04). The percentage of patients transfused was 92.1% in the CPB group and 72.6% in the OPCAB group (P<0.01). Postoperative myocardial infarction occurred in 11.3% in the CPB group and 14.5% in the OPCAB group (P=NS). For all the parameters entered in the multivariate analysis with logistic regression model, the type of surgery (CPB or OPCAB) was an independent predictor of operative mortality and stroke (P=0.0375). The odds ratio (OR) indicates that operative mortality and stroke occur 4 times (OR=4.171) more often in CPB patients than in OPCAB patients. Follow-up showed no significant difference between the 2 groups in terms of cardiac events and mortality.

CONCLUSIONS

This retrospective study suggests a benefit of OPCAB in terms of operative mortality and stroke for octogenarian patients when compared with CPB in our institution.

Authors+Show Affiliations

Research Center and Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12354700

Citation

Demaria, Roland G., et al. "Reduced Mortality and Strokes With Off-pump Coronary Artery Bypass Grafting Surgery in Octogenarians." Circulation, vol. 106, no. 12 Suppl 1, 2002, pp. I5-10.
Demaria RG, Carrier M, Fortier S, et al. Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians. Circulation. 2002;106(12 Suppl 1):I5-10.
Demaria, R. G., Carrier, M., Fortier, S., Martineau, R., Fortier, A., Cartier, R., Pellerin, M., Hébert, Y., Bouchard, D., Pagé, P., & Perrault, L. P. (2002). Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians. Circulation, 106(12 Suppl 1), I5-10.
Demaria RG, et al. Reduced Mortality and Strokes With Off-pump Coronary Artery Bypass Grafting Surgery in Octogenarians. Circulation. 2002 Sep 24;106(12 Suppl 1):I5-10. PubMed PMID: 12354700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians. AU - Demaria,Roland G, AU - Carrier,Michel, AU - Fortier,Simon, AU - Martineau,Raymond, AU - Fortier,Annick, AU - Cartier,Raymond, AU - Pellerin,Michel, AU - Hébert,Yves, AU - Bouchard,Denis, AU - Pagé,Pierre, AU - Perrault,Louis P, PY - 2002/10/2/pubmed PY - 2002/10/22/medline PY - 2002/10/2/entrez SP - I5 EP - 10 JF - Circulation JO - Circulation VL - 106 IS - 12 Suppl 1 N2 - BACKGROUND: Off-pump coronary artery bypass surgery (OPCAB) has been revived and has gained popularity, although the exact subsets of patients who might benefit most from this technique are unknown. The aim of this retrospective study was to compare the results of coronary artery bypass grafting surgery (CABG) in octogenarians using cardiopulmonary bypass (CPB) or OPCAB techniques. METHODS AND RESULTS: Over a 5-year period (1995-1999), 125 patients older than 80 years of age were operated for isolated myocardial revascularization (63 using CPB and 62 with OPCAB). There was no statistically significant difference in preoperative comorbidities between groups or in mean left ventricular ejection fraction (54.5+/-15.3% in the CPB group and 50.9+/-13.5% in the OPCAB group, respectively). The mean number of distal anastomosis per patient was 2.9 in CPB group and 2.6 in OPCAB group (P=ns). The majority of patients in both groups had unstable angina and were operated on an urgent basis. The operative mortality was 15.9% in the CPB group and 4.8% in the OPCAB group (P=0.04). There were 4 postoperative strokes (6.3%) in the CPB group and none (0%) in the OPCAB group (P=0.04). The percentage of patients transfused was 92.1% in the CPB group and 72.6% in the OPCAB group (P<0.01). Postoperative myocardial infarction occurred in 11.3% in the CPB group and 14.5% in the OPCAB group (P=NS). For all the parameters entered in the multivariate analysis with logistic regression model, the type of surgery (CPB or OPCAB) was an independent predictor of operative mortality and stroke (P=0.0375). The odds ratio (OR) indicates that operative mortality and stroke occur 4 times (OR=4.171) more often in CPB patients than in OPCAB patients. Follow-up showed no significant difference between the 2 groups in terms of cardiac events and mortality. CONCLUSIONS: This retrospective study suggests a benefit of OPCAB in terms of operative mortality and stroke for octogenarian patients when compared with CPB in our institution. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/12354700/Reduced_mortality_and_strokes_with_off_pump_coronary_artery_bypass_grafting_surgery_in_octogenarians_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=12354700.ui DB - PRIME DP - Unbound Medicine ER -