Predictors of prolonged mechanical ventilation following aorta no-touch off-pump coronary artery bypass surgery.
OBJECTIVE
To identify parameters associated with prolonged mechanical ventilation (PMV) (>48 h) after off-pump coronary artery bypass (OPCAB) in our patient population.


METHODS
From February 2001 to November 2005, we operated on 1359 patients for isolated coronary revascularization with the pi-circuit technique, consisting of: (1) beating heart, (2) OPCAB, (3) aorta no-touch, (4) use of composite grafts, and (5) arterial revascularization.


RESULTS
From the total number of our patients, 1320 patients had been extubated within 48 h postoperatively (Group A) and 39 patients needed PMV (Group B). In our study we have found that PMV were associated with advanced age (64.74+/-9.85 Group A vs 68.43+/-10.03 Group B, p<0.02) as well as higher incidence with octogenarians (4.4% Group A vs 10.2% Group B, p=0.09). Patients with preoperative history of transient ischemic attacks (TIAs) or stroke were more likely to belong to Group B (1.5% Group A vs 7.7% Group B, p<0.02; 2.8% Group A vs 10.3% Group B, p<0.02, respectively). Preoperative intra-aortic balloon pump (IABP) insertion was associated with PMV (1.6% Group A vs 15.4% Group B, p<0.0005). Unexpectedly, neither COPD nor obesity was associated with PMV (4.9% Group A vs 7.7% Group B, p=NS, 21.7% Group A vs 23.1% Group B, p=NS, respectively).


CONCLUSIONS
In this study, PMV following aorta no-touch OPCAB was related to preoperative variables: age, octogenarians, preoperative IABP, TIA, and stroke. There was no relation between PMV and any of the operative data.
Prapas
Sotirios N
SN
Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece.
Panagiotopoulos
Ioannis A
IA
Hamed Abdelsalam
Ashraf
A
Kotsis
Vasilios N
VN
Protogeros
Dimitrios A
DA
Linardakis
Ioannis N
IN
Danou
Fotini N
FN
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012121:Respiration, Artificial; D018570:Risk Assessment; D012307:Risk Factors; D016276:Ventricular Function / Q000502:physiology