title: Outcome after coronary artery bypass surgery with miniaturized versus conventional cardiopulmonary bypass.
abstract: We have reviewed the results of our experience with the use of miniaturized (Mini-CPB) versus conventional (C-CPB) cardiopulmonary bypass in coronary artery bypass surgery (CABG). This study included 365 patients who underwent CABG with C-CPB and 101 patients with Mini-CPB. In-hospital mortality was lower in the C-CPB group (1.4% vs. 3.0%, P = 0.38). A better, but not statistically significant, immediate outcome was observed in the C-CPB group as indicated by a shorter length of stay in the intensive care unit as well as a lower incidence of combined adverse end-point. However, this was probably due to significantly higher operative risk in the Mini-CPB group (logistic EuroSCORE: 8.5 +/- 10.0 vs. 4.6 +/- 7.1, P < 0.0001). Seventy-seven propensity score-matched pairs had similar immediate postoperative results after Mini-CPB and C-CPB (30-day mortality: 1.3% vs. 1.3%; stroke: 0% vs. 0%; intensive care unit stay > or = 5 days: 6.5% vs. 9.1%; combined adverse events: 14.3% vs. 11.7%). Mini-CPB achieves similar results to C-CPB in patients undergoing isolated CABG. The potential efficacy of Mini-CPB is expected to be more evident in high-risk patients or in complex cardiac surgery requiring much longer cardiopulmonary perfusion.
authors.affiliation: Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Rimpiläinen
authors.forename: F
authors.initials: F
authors.lastname: Biancari
authors.forename: J O
authors.initials: JO
authors.lastname: Wistbacka
authors.forename: P
authors.initials: P
authors.lastname: Loponen
authors.forename: S P
authors.initials: SP
authors.lastname: Koivisto
authors.forename: J
authors.initials: J
authors.lastname: Rimpiläinen
authors.forename: K
authors.initials: K
authors.lastname: Teittinen
authors.forename: J
authors.initials: J
authors.lastname: Nissinen
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008904:Miniaturization; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome