Off-pump coronary artery bypass grafting in left ventricular dysfunction.
Between August 2004 and May 2006, 124 patients undergoing coronary artery bypass grafting with ejection fractions <or= 35% were randomly assigned to off-pump or conventional procedures. Preoperative characteristics were the same in both groups, except for age and degree of mitral regurgitation. Off-pump coronary artery grafting was carried out using a tissue stabilizer and a single-suture technique; conventional coronary bypass employed cardiopulmonary bypass, moderate hypothermia, and antegrade-retrograde cold blood cardioplegic arrest. There were significantly fewer vessels grafted (3.09 +/- 0.41) in the off-pump group than in those who had a conventional procedure (3.42 +/- 0.86). The rates of mortality, morbidity, balloon pump support, inotropic usage, gastrointestinal bleeding, renal dysfunction, reintubation, as well as intensive care and hospital stay, were significantly lower in the off-pump group. The incidence of perioperative myocardial infarction did not differ significantly between groups. The results of this study indicate that beating-heart coronary bypass is safe and effective in patients with left ventricular dysfunction.
Masoumi
Masoumali
M
Department of Cardiovascular Surgery, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. mmasoumi@kums.ac.ir
Saidi
Mohammad R
MR
Rostami
Farhanaz
F
Sepahi
Helen
H
Roushani
Daem
D
D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D051437:Renal Insufficiency / Q000209:etiology; D012121:Respiration, Artificial; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery
D002316:Cardiotonic Agents