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Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction.
Eur J Cardiothorac Surg. 2011 Jul; 40(1):227-32.EJ

Abstract

OBJECTIVE

Off-pump coronary artery bypass surgery (OPCAB) and beating-heart coronary artery bypass grafting (BH-CAB) performed with cardiopulmonary bypass support are used with increasing frequency in the treatment of coronary artery occlusive disease. The utility of OPCAB and BH-CAB in treating high-risk patients has been studied, but the effects of these procedures on ventricular function have not been thoroughly investigated.

METHODS

Data were collected from a database encompassing all patients who underwent isolated coronary revascularization performed by a single surgeon between August 2002 and March 2007. All procedures (n = 507) began as OPCAB operations, but 99 were converted to BH-CAB during surgery. Each patient's ejection fraction (EF) was measured preoperatively and postoperatively (median, 5.0 days after surgery).

RESULTS

We found that although the BH-CAB patients tended to be in worse health and to have a lower preoperative EF than the OPCAB patients, both groups of patients had similar improvements in postoperative EF (6.8% vs 5.4%; p = 0.65). In addition, multivariable linear regression showed that a lower preoperative EF, age ≥ 70 years, and cardiomegaly predicted less postoperative EF improvement after coronary revascularization by either OPCAB or BH-CAB.

CONCLUSIONS

Both OPCAB and BH-CAB procedures produce significant and similar short-term improvement in EF in patients with coronary disease. This change in EF may account for the subjective clinical improvements seen early after both procedures.

Authors+Show Affiliations

Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX, USA. George.v.letsou@uth.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21273086

Citation

Letsou, George V., et al. "Off-pump Coronary Artery Bypass and Avoidance of Hypothermic Cardiac Arrest Improves Early Left Ventricular Function in Patients With Systolic Dysfunction." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 40, no. 1, 2011, pp. 227-32.
Letsou GV, Wu YX, Grunkemeier G, et al. Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction. Eur J Cardiothorac Surg. 2011;40(1):227-32.
Letsou, G. V., Wu, Y. X., Grunkemeier, G., Rampurwala, M. M., Kaiser, L., & Salaskar, A. L. (2011). Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 40(1), 227-32. https://doi.org/10.1016/j.ejcts.2010.11.005
Letsou GV, et al. Off-pump Coronary Artery Bypass and Avoidance of Hypothermic Cardiac Arrest Improves Early Left Ventricular Function in Patients With Systolic Dysfunction. Eur J Cardiothorac Surg. 2011;40(1):227-32. PubMed PMID: 21273086.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction. AU - Letsou,George V, AU - Wu,Ying Xing, AU - Grunkemeier,Gary, AU - Rampurwala,Murtuza M, AU - Kaiser,Larry, AU - Salaskar,Abhijit L, Y1 - 2011/01/26/ PY - 2010/07/06/received PY - 2010/11/01/revised PY - 2010/11/04/accepted PY - 2011/1/29/entrez PY - 2011/1/29/pubmed PY - 2012/1/14/medline SP - 227 EP - 32 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 40 IS - 1 N2 - OBJECTIVE: Off-pump coronary artery bypass surgery (OPCAB) and beating-heart coronary artery bypass grafting (BH-CAB) performed with cardiopulmonary bypass support are used with increasing frequency in the treatment of coronary artery occlusive disease. The utility of OPCAB and BH-CAB in treating high-risk patients has been studied, but the effects of these procedures on ventricular function have not been thoroughly investigated. METHODS: Data were collected from a database encompassing all patients who underwent isolated coronary revascularization performed by a single surgeon between August 2002 and March 2007. All procedures (n = 507) began as OPCAB operations, but 99 were converted to BH-CAB during surgery. Each patient's ejection fraction (EF) was measured preoperatively and postoperatively (median, 5.0 days after surgery). RESULTS: We found that although the BH-CAB patients tended to be in worse health and to have a lower preoperative EF than the OPCAB patients, both groups of patients had similar improvements in postoperative EF (6.8% vs 5.4%; p = 0.65). In addition, multivariable linear regression showed that a lower preoperative EF, age ≥ 70 years, and cardiomegaly predicted less postoperative EF improvement after coronary revascularization by either OPCAB or BH-CAB. CONCLUSIONS: Both OPCAB and BH-CAB procedures produce significant and similar short-term improvement in EF in patients with coronary disease. This change in EF may account for the subjective clinical improvements seen early after both procedures. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/21273086/Off_pump_coronary_artery_bypass_and_avoidance_of_hypothermic_cardiac_arrest_improves_early_left_ventricular_function_in_patients_with_systolic_dysfunction_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2010.11.005 DB - PRIME DP - Unbound Medicine ER -