Off-pump versus on-pump coronary artery revascularization: effects on pulmonary function.
Many studies have shown important changes in lung function tests after coronary artery surgeries. It is controversial if off-pump surgery can give a better and shorter recovery than the on-pump. A prospective study was conducted on 42 patients submitted to coronary artery surgery and divided into two groups: 21 off-pump using intraluminal shunt (G (I)) and 21 on-pump (G (II)), matched by the anatomical location of the coronary arteries lesions. All patients had spirometric evaluation, blood gas measurements and alveolo-arterial oxygen gradient (A-aDO(2)), at the fourth and 10th postoperative days (PO(4) and PO(10)). Preoperatively, G(I) and G(II) had similar results (P>0.372). Spirometry showed decreases at PO(4) and remained decreased until PO(10) for both groups, with significant differences between the groups. The blood gas measurements showed reduction in arterial oxygen pressure (PaO(2)) and carbon dioxide pressure (PaCO(2)), while there was an increase in A-aDO(2) at PO(4) and PO(10) in both groups. The results suggest that different changes occur in pulmonary function when the surgery is performed with or without cardiopulmonary bypass. The off-pump patients showed significantly greater improvement than the on-pump group.
e Silva
Ana M R P
AM
Department of Surgery, Santa Casa de São Paulo, Faculty of Medical Sciences, São Paulo, Brazil. ana.mrp@uol.com.br
Saad
Roberto
R
Stirbulov
Roberto
R
Rivetti
Luiz A
LA
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002245:Carbon Dioxide / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D020127:Recovery of Function; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
D015415:Biomarkers; D002245:Carbon Dioxide; D010100:Oxygen