Siordia ZA, Anaya GJ, Siordia ZR

Language: Spanish
References: 0
Page: 107-110
PDF size: 92.28 Kb.

ABSTRACT

Background: In an effort to avoid the known deleterious effects associated with the use of cardiopulmonary bypass during myocardial revascularization procedures and its economic cost, increased attention has been focused on coronary bypass procedures without the heart lung machine. We report our results with 50 patients who underwent off pump coronary artery bypass (OPCAB) using the median sternotomy approach. Methods: Fifty patients submitted to Off-Pump Coronary Artery Bypass (OPCAB) using the median sternotomy approach, were compared with a similar number of patients operated with the conventional coronary bypass method using the heart - lung machine. Patients where adjusted for age, gender, number of diseased vessels, ejection fraction and concurrent illnesses. Results: Arterial and vein grafts were used in both groups, with an average of 2.7 grafts in the OPCAB group, and 3.1 in the control group. Variables analyzed included: intra-aortic balloon pulsation (p = NS) inotropic amines requirements for › 48 hrs. (p = NS); renal failure (p = NS), postoperative myocardial infarction (p = NS) reoperation for bleeding (p = NS); ventricular arrhythmia (p = NS) and death (p = NS). Variables that did result in a significant difference where: transfusion requirements (p = 0.0001), hospital length. of stay (p = 0.0001) and total hospital cost. Conclusions: Recent advances in surgical strategies along with the development of heart stabilization equipment, allows for complete myocardial revascularization with good quality anastomosis while avoiding the use of cardiopulmonary bypass. Even though we found no difference in regards to frequent postoperative complications, the significantly reduced need for blood transfusions, hospital stay and total cost of the procedure warrants more consideration of “Off-Pump” cardiac surgical procedures.