Efficacy and safety of on-pump beating heart surgery.
BACKGROUND
Beating-heart surgery with warm blood perfusion, instead of cardioplegic solution, has been widely accredited to be a feasible technique in the cardiac operation. However, few studies have addressed the efficacy and safety of on-pump beating-heart surgery, especially with large numbers of patients. In this study, the efficacy and safety of on-pump beating-heart surgery was evaluated by surveying 701 patients with cardiac disease.


METHODS
Preoperative risk factors, intraoperative techniques, and postoperative complications were documented and evaluated in 701 consecutive patients (from January 1, 2002, to December 30, 2006) who underwent beating-heart surgery with continuous antegrade or retrograde warm blood perfusion at The People's Hospital of Guangxi Zhuang Autonomous Region.


RESULTS
Among the 701 patients with beating-heart surgery, antegrade perfusion was used in 556 patients (79.32%); retrograde perfusion was used in 40 patients (5.71%); and retrograde perfusion followed by antegrade perfusion was performed in 93 patients (13.27%). Cardioplegic arrest was required in 12 patients (1.71%) for inadequate visualization. In 4 of 701 patients (0.57%) low cardiac output syndrome occurred. Hemoglobinuria occurred in 16 patients (2.28%). No air embolization or permanent high-degree atrioventricular block occurred in these patients. The crude mortality of the surveyed patients was 2.43% (17 of 701).


CONCLUSIONS
Our results indicate that on-pump beating-heart surgery is a relatively safe and reliable technique for treatment of cardiac diseases.
Mo
Ansheng
A
The Medical College of Wuhan University, Wuhan, China.
Lin
Hui
H
Wen
Zhaoke
Z
Lu
Weijun
W
Long
Xiaomao
X
Zhou
Yifang
Y
D000328:Adult; D002315:Cardiopulmonary Bypass / Q000379:methods* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002681:China; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome