[Single clamp technique in elderly patients undergoing coronary artery surgery].
OBJECTIVE
The results of single clamp and partial clamp techniques were retrospectively compared in elderly patients (>70 years) undergoing coronary artery bypass grafting operation (CABG).


METHODS
A total of 244 elderly patients undergoing CABG between January 1995 and March 2002 in our center were studied. Single-clamp technique was used in 32 cases (Group 1) and partial-clamp technique was used in 212 cases (Group 2). All patients had isolated coronary artery lesions and a primary elective coronary bypass grafting surgery was planned for every case. Preoperative, operative and postoperative variables; age, gender, pre- and post-operative neurological status (stroke, amaurosis fugax, aphasia, hemiplegia, hemiparesis), cerebrovascular diseases, diabetes mellitus, hypertension, number of distal grafts, left ventricular score, durations of aortic cross-clamping and cardiopulmonary bypass (CPB) times, perfusion pressure during CPB, and postoperative cardiac status were recorded. Patients with a history of neurological complications were excluded from the study.


RESULTS
Overall, mean age was 71.9+/-2.18 years. Patients in Group 1 were significantly older as compared to patients in Group 2 (p< 0.01). Average duration of cross-clamping in Group 1 was significantly longer (p<0.001) compared to Group 2, but there were no differences with regard to the total duration of cardiopulmonary bypass (p=0.535). No patients had neurological complications in Group 1, however 22 patients in Group 2 had neurological complications (p<0.05).


CONCLUSIONS
Although single-clamp technique was associated with a longer cross-clamp time, the duration of CPB was not increased and the incidence of neurological complications was low.
Us
Melih Hulusi
MH
Clinic of Cardiovascular Surgery, Gülhane Military Medical Academy Haydarpaşa Education Hospital, Kadiköy, Istanbul. melihus@superonline.com
Süngün
Mutasim
M
Cağli
Kerim
K
Yilmaz
Mert
M
Pekedis
Alaaddin
A
Oztürk
Omer Yüksel
OY
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey