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OPCAB Group (opcab + group)
Selected AbstractsACQUIRED CARDIOVASCULAR DISEASE Original Articles: A Prospective Observational Study to Compare Conventional Coronary Artery Bypass Grafting Surgery with Off-Pump Coronary Artery Bypass Grafting on Basis of EuroSCOREJOURNAL OF CARDIAC SURGERY, Issue 5 2010Pawan Singhal M.Ch. Off-pump coronary bypass (OPCAB) surgery has become a widely used technique during recent years. EuroSCORE risk scale is the most rigorously evaluated scoring system in cardiac surgery to preoperatively quantify the risk of death and other serious postoperative complications. The aim of this prospective observational study was to compare the mortality and morbidity between OPCAB and conventional CABG in three major preoperative groups as assessed by EuroSCORE. Material and Method: All consecutive patients undergoing isolated coronary artery bypass surgery between January 2003 and December 2004 at Wellington Hospital were included. In this period, 347 patients had conventional CABG and 254 patients had OPCAB. Data were prospectively collected according to Australasian Society of Cardiothoracic Surgeons' cardiac surgery data set. The preoperative additive EuroSCORE was computed in each patient and the patients were divided into three risk groups. Results of OPCAB and conventional CABG were compared on basis of EuroSCORE group. Results: OPCAB surgery is preferably performed in patients with low-risk. OPCAB group had lesser number of grafts per patient. When adjusted with risk score, there was no statistically significant difference in mortality in any of the three groups. No significant difference was found for stroke, renal dysfunction, atrial fibrillation, re-exploration for bleeding, deep sternal wound infection, or pulmonary complications in either of three groups. However, inotropic requirement and requirements of blood products were less in OPCAB group. Conclusion: OPCAB does not offer any significant advantage in terms of mortality and morbidity over conventional CABG.,(J Card Surg 2010;25:495-500) [source] Introduction of an OPCAB Program Aimed at Total Arterial Grafting in a Multidisciplinary Setting: Feasible and Safe?JOURNAL OF CARDIAC SURGERY, Issue 2 2007Xavier M. Mueller M.D. Uniform surgical and anesthetic protocols were established and applied throughout the study period. Methods: From March 2003,when the first OPCAB procedure of the program was performed,to July 2004, the data related to all the coronary artery bypass grafting procedures (N = 408) were prospectively recorded. The program was divided into two stages: the purpose of the first stage was to perform OPCAB in more than 90% of the patients, and that of the second stage was to proceed toward total arterial revascularization. The patients were grouped into four periods (102 patients for each period). Comparisons were performed with analysis of variance test and chi-square test where appropriate. Results: For periods 1 to 4, the number of OPCAB procedures was 65/102 (64%), 82/102 (80%), 97/102 (95%), and 99/102 (97%), respectively (p < 0.001). The number of conversions did not vary significantly throughout the study (overall: 7/408, 1.7%), neither did the number of bypass/patient (overall: 3.05 ± 0.86). The number of arterial graft/patient was 1.03 ± 0.64, 1.01 ± 0.4, 1.29 ± 0.64, and 2.56 ± 1, respectively (p < 0.001). During the last period, 81% (253/312) of the grafts were arterial. Overall mortality was 4.6% (19/408). For the OPCAB group, mortality was 2.9% (10/343) and perioperative myocardial infarction rate was 1.5% (5/343) with no statistically significant difference between the periods. Conclusions: With predefined standardized and coordinated protocols, an OPCAB program aimed at total arterial revascularization can be implemented rapidly and safely in a multidisciplinary setting. [source] CT02 A STUDY TO EVALUATE VARIOUS TECHNIQUES OF CORONARY ARTERY BYPASS GRAFTINGANZ JOURNAL OF SURGERY, Issue 2007P. Singhal Introduction In Wellington Hospital, CABG is being performed by various techniques like OPCAB, On-pump cardioplegic arrest, fibrillatory arrest and On-pump beating heart. Aim This study was undertaken to compare morbidity and mortality between On- pump CABG and OPCAB on basis of Euroscore. Material and Method From January 2003 till December 2004, data were collected according to Australasian society of Cardiothoracic surgery data set. Euroscores were calculated and patients were divided into 3 groups. Results of OPCAB and On-pump CABG were compared on basis of Euroscore group. In this period we performed 350 On-pump CABG and 254 OPCAB. Results OPCAB group had less number of grafts per patients. Even for triple vessel disease numbers of grafts were lower in OPCAB group. OPCAB group had more patients with total arterial revascularization. There were 10 deaths in On-pump group and 1 in OPCAB group. In the low and moderate risk group there was no significant difference in hospital stay, ventilation hours and ICU stay. However inotropic requirement and requirements of blood products were less in OPCAB group. There was no statistically significant difference between Incidence of new renal failure or arrhythmia in two groups. 2 patients in each group had blocked graft in immediate postop period and required revascularization. There were only 5 patients in the high-risk group in OPCAB making intergroup comparisons difficult. Conclusion OPCAB does not offer any significant advantage in terms of mortality and morbidity over On-pump CABG. To evaluate the effects of number of grafts and total arterial revascularization, it needs a long-term follow-up. [source] Beating-Heart Coronary Artery Bypass Grafting With Miniaturized Cardiopulmonary Bypass Results in a More Complete Revascularization When Compared to Off-Pump GraftingARTIFICIAL ORGANS, Issue 3 2010Delawer Reber Abstract The technique of miniaturized cardiopulmonary bypass (M-CPB) for beating-heart coronary artery bypass grafting (CABG) is relatively new and has potential advantages when compared to conventional cardiopulmonary bypass (CPB). M-CPB consists of less tubing length and requires less priming volume. The system is phosphorylcholine coated and results in minimal pump-related inflammatory response and organ injury. Finally, this technique combines the advantages of the off-pump CABG (OPCAB) with the better exposure provided by CPB to facilitate complete revascularization. The hypothesis is that CABG with M-CPB has a better outcome in terms of complete coronary revascularization and perioperative results as that compared to off-pump CABG (OPCAB). In a retrospective study, 302 patients underwent beating-heart CABG, 117 (39%) of them with the use of M-CPB and 185 (61%) with OPCAB. After propensity score matching 62 patients in both groups were demographically similar. The most important intra- and early-postoperative parameters were analyzed. Endpoints were hospital mortality and complete revascularization. Hospital mortality was comparable between the groups. The revascularization was significantly more complete in M-CPB patients than in patients in the OPCAB group. Beating-heart CABG with M-CPB is a safe procedure and it provides an optimal operative exposure with significantly more complete coronary revascularization when compared to OPCAB. Beating-heart CABG with the support of a M-CPB is the operation of choice when total coronary revascularization is needed. [source] | ||||||||||