Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 452-457
https://doi.org/10.2298/SARH1108452P
Full text ( 193 KB)
Cited by
Surgical revascularization on the beating heart in patients with low ejection fraction
Putnik Svetozar (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Velinović Miloš (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Mikić Aleksandar (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Vraneš Mile (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Nikolić Bojan (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd)
Krstić Nevena (Medicinski fakultet, Beograd + Klinika za fizikalnu medicinu, Klinički centar Srbije, Beograd)
Ristić Miljko (Klinika za kardiohirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Introduction. The subset of patients most likely to benefit from off-pump
coronary artery bypass grafting (OPCABG) remains a controversial issue, but
the technique has been proposed to decrease postoperative mortality and
morbidity. Coronary artery bypass grafting (CABG) with a cardiopulmonary
bypass carries a significant risk for patients with severe left ventricular
(LV) dysfunction. Objective. The objective of this study was to compare
off-pump to on-pump CABG in patients with ejection fraction (EF) lower than
30%. Methods. Prospective randomized study was carried out between June 2004
and March 2006 at the Institute for Cardiovascular Diseases of the Clinical
Centre of Serbia. Sixty prospectively randomized high-risk patients divided
into two groups to undergo off-pump or on-pump CABG. All recruited patients
had left ventricular ejection fraction lower than 30%. Results. Thirty
patients averaging 59.2 years of age underwent 2.30 grafts on pump, and
another 30 averaging 59.6 years of age underwent 2.03 grafts off pump. OPCABG
patients exhibited a significantly less release of TnI (average 0.71 μ/L)
than on-pump patients (3.00 μ/L). Inotropic requirements were less in the
off-pump group. The patients undergoing OPCABG received fewer units of blood
and had shorter postoperative length of stay in intensive care unit and
hospital stay. There was no significant difference in hospital mortality and
complication rate. Conclusion. The present study suggests that off-pump CABG
in patients with poor LV function when compared with conventional CABG
achieved similar number of grafts per patient, similar in-hospital outcomes,
shorter length of stay, reduced transfusion requirement, and less myocardial
injury.
Keywords: CABG, beating heart, low ejection fraction
More data about this article available through SCIndeks