Espronceda SK, Massip NJ, Jerez CAM, González TA, Díaz LJ

Language: Spanish
References: 25
Page: 350-357
PDF size: 361.83 Kb.

ABSTRACT

Introduction: The development and refinement of techniques in cardiac surgery have contributed significantly to improve the prognosis of coronary artery disease. Among these forms of intervention, the off-pump and on-pump coronary artery sur-gery stand out.
Objective: To compare both surgical techniques according to the incidence of com-plications in the immediate postoperative period.
Method: A retrospective descriptive study was carried out at the Instituto de Cardi-ología y Cirugía Cardiovascular of Havana, Cuba, in 2017. The study’s population was constituted by patients operated by coronary-artery bypass grafting and the sample, was intentionally formed by 100 patients who were divided into two groups: group 1, 57 patients operated without cardiopulmonary bypass and group 2, 43 pa-tients with cardiopulmonary bypass. Demographic variables related to the surgical procedure, complications during postoperative period and mortality were analyzed.
Results: Males (73.43%) and on-pump coronary-artery bypass grafting (54.68%) pre-vailed. Although three-vessel coronary artery disease was the main angiographic diagnosis in both groups, more complete revascularization procedures —with im-plantation of three or more grafts— were performed in group 2 (93.1% vs. 40.0%). The most frequent complications in group 1 were the respiratory ones, followed by al-terations of the internal environment (hypokalemia, hyperglycemia). Emergency re-operation was performed in 5.71% of patients from group 1 and in 17.24% from group 2. Mortality was higher in group 2 (3.51 vs. 16.28%).
Conclusions: Although postoperative period complications were similar in both groups, mortality was much lower in those revascularized with beating heart, which could be related to preoperative risk factors, the extent of ischemic disease treated, and other variables dependent on the surgical procedure.

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