Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

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dc.contributor.authorCaputti, Guido Marco [UNIFESP]
dc.contributor.authorFonseca, José Honório de Almeida Palma da [UNIFESP]
dc.contributor.authorGaia, Diego Felipe [UNIFESP]
dc.contributor.authorBuffolo, Enio [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2015-06-14T13:42:43Z
dc.date.available2015-06-14T13:42:43Z
dc.date.issued2011-01-01
dc.description.abstractOBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112) or without (off-pump) (105) the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump): total length of hospital stay (days)-11.3 vs. 7.2, length of ICU stay (days)-3.7 vs. 2.1, pulmonary complications-10.7% vs. 2.8%, intubation time (hours)-22 vs. 10, postoperative bleeding (mL)-654 vs. 440, acute renal failure-8.9% vs. 1.9% and left-ventricle ejection fraction before discharge-22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Cardiovascular Surgery
dc.description.affiliationUnifespUNIFESP, Cardiovascular Surgery
dc.description.sourceSciELO
dc.format.extent2049-2053
dc.identifierhttp://dx.doi.org/10.1590/S1807-59322011001200009
dc.identifier.citationClinics. Faculdade de Medicina / USP, v. 66, n. 12, p. 2049-2053, 2011.
dc.identifier.doi10.1590/S1807-59322011001200009
dc.identifier.fileS1807-59322011001200009.pdf
dc.identifier.issn1807-5932
dc.identifier.scieloS1807-59322011001200009
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/6136
dc.identifier.wosWOS:000298331400009
dc.language.isoeng
dc.publisherFaculdade de Medicina / USP
dc.relation.ispartofClinics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCoronary artery bypassen
dc.subjectcardiopulmonary bypassen
dc.subjectoff-pump surgeryen
dc.subjectejection fractionen
dc.subjectcardiac dysfunctionen
dc.titleOff-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular functionen
dc.typeinfo:eu-repo/semantics/article
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