Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles
BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients...
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| Format: | Article |
| Language: | English |
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King Faisal Specialist Hospital and Research Centre
2014-05-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2014.222 |
| _version_ | 1818695044452843520 |
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| author | Lei Yu Tianxiang Gu Enyi Shi Chun Wang Qin Fang Yang Yu Xiaoqi Zhao Cheng Qian |
| author_facet | Lei Yu Tianxiang Gu Enyi Shi Chun Wang Qin Fang Yang Yu Xiaoqi Zhao Cheng Qian |
| author_sort | Lei Yu |
| collection | DOAJ |
| description | BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients with enlarged ventricles remains controversial. This prospective randomized study was designed to characterize comparison of early clinical outcome and mid-term follow-up following ONCAB versus OPCAB in patients with triple-vessel disease and enlarged ventricles. DESIGN AND SETTINGS: Prospective randomized trial of patients treated at The First Affiliated Hospital, China Medical University, over a 3-year period (2007–2010). METHODS: A total of 102 patients with triple-vessel disease and enlarged ventricles (end-diastolic dimension ≥6.0 cm) were randomized to OPCAB or ONCAB between July 2007 and December 2010. The in-hospital outcomes were analyzed. The study included a mid-term follow-up, with a mean follow-up time of 49.40 (12.88 months). RESULTS: No significant differences were recorded in the baseline clinical characteristics of ONCAB and OPCAB groups. A statistical difference was found between the two groups at the time of extubation, intensive care unit stay, hospital stay, blood requirements, incidence of intra-aortic balloon pump support, pulmonary complications, stroke, reoperation for bleeding, and inotropic requirements >24 hours (P<.05). The number of anastomoses performed per patient, the incidence of postoperative ventricular arrhythmia, myocardial infarction, new-onset atrial fibrillation, hemodialysis, infective complications, recurrent angina, and percutaneous reintervention were similar between the 2 groups (P>.05). The left ventricular end-diastolic dimension was significantly smaller at 6 months' follow-up in the 2 groups than it was before operation (<.05). No differences in hospital mortality and mid-term mortality between OPCAB and ONCAB groups were found. During the follow-up, no patient in either group had undergone repeat coronary artery bypass grafting. CONCLUSION: No differences in early and mid-term mortality were found between OPCAB and ONCAB in patients with triple-vessel disease and enlarged ventricles. However, OPCAB seems to have a beneficial effect on postoperative complications. |
| first_indexed | 2024-12-17T13:39:13Z |
| format | Article |
| id | doaj.art-6d1e0676fa4b4814bcb0add7f0440f34 |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-12-17T13:39:13Z |
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| publisher | King Faisal Specialist Hospital and Research Centre |
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| series | Annals of Saudi Medicine |
| spelling | doaj.art-6d1e0676fa4b4814bcb0add7f0440f342022-12-21T21:46:21ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662014-05-0134322222810.5144/0256-4947.2014.222asm-3-222Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventriclesLei Yu0Tianxiang Gu1Enyi Shi2Chun Wang3Qin Fang4Yang Yu5Xiaoqi Zhao6Cheng Qian7From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001From the Department of Cardiac Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China 110001BACKGROUND AND OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) is a popular treatment for patients with ischemic heart disease, especially for high-risk patients. However, whether OPCAB can lead to better clinical outcomes than on-pump coronary artery bypass grafting (ONCAB) in patients with enlarged ventricles remains controversial. This prospective randomized study was designed to characterize comparison of early clinical outcome and mid-term follow-up following ONCAB versus OPCAB in patients with triple-vessel disease and enlarged ventricles. DESIGN AND SETTINGS: Prospective randomized trial of patients treated at The First Affiliated Hospital, China Medical University, over a 3-year period (2007–2010). METHODS: A total of 102 patients with triple-vessel disease and enlarged ventricles (end-diastolic dimension ≥6.0 cm) were randomized to OPCAB or ONCAB between July 2007 and December 2010. The in-hospital outcomes were analyzed. The study included a mid-term follow-up, with a mean follow-up time of 49.40 (12.88 months). RESULTS: No significant differences were recorded in the baseline clinical characteristics of ONCAB and OPCAB groups. A statistical difference was found between the two groups at the time of extubation, intensive care unit stay, hospital stay, blood requirements, incidence of intra-aortic balloon pump support, pulmonary complications, stroke, reoperation for bleeding, and inotropic requirements >24 hours (P<.05). The number of anastomoses performed per patient, the incidence of postoperative ventricular arrhythmia, myocardial infarction, new-onset atrial fibrillation, hemodialysis, infective complications, recurrent angina, and percutaneous reintervention were similar between the 2 groups (P>.05). The left ventricular end-diastolic dimension was significantly smaller at 6 months' follow-up in the 2 groups than it was before operation (<.05). No differences in hospital mortality and mid-term mortality between OPCAB and ONCAB groups were found. During the follow-up, no patient in either group had undergone repeat coronary artery bypass grafting. CONCLUSION: No differences in early and mid-term mortality were found between OPCAB and ONCAB in patients with triple-vessel disease and enlarged ventricles. However, OPCAB seems to have a beneficial effect on postoperative complications.https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2014.222 |
| spellingShingle | Lei Yu Tianxiang Gu Enyi Shi Chun Wang Qin Fang Yang Yu Xiaoqi Zhao Cheng Qian Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles Annals of Saudi Medicine |
| title | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
| title_full | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
| title_fullStr | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
| title_full_unstemmed | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
| title_short | Off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel disease and enlarged ventricles |
| title_sort | off pump versus on pump coronary artery bypass surgery in patients with triple vessel disease and enlarged ventricles |
| url | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2014.222 |
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