Outcome after coronary artery bypass surgery with miniaturized versus conventional cardiopulmonary bypass.
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.
Rimpiläinen
R
R
Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
Biancari
F
F
Wistbacka
J O
JO
Loponen
P
P
Koivisto
S P
SP
Rimpiläinen
J
J
Teittinen
K
K
Nissinen
J
J
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