Showing 3 results for Off-Pump
Mirkhani S. H, Delavarkhan S. M, Radmehr H,
Volume 60, Issue 1 (4-2002)
Abstract
In recent years off-pump coronary artery bypass surgery (OPCAB) has emerged as preferred method for revascularization of coronary arteries in relatively selected group of patients. Considering patients receiving incomplete revascularization need significantly higher postoperative catheterization and re-intervention (PTCA or CABG), we performed this study to identify safety and feasibility of this technique for total revascularization in nearly all patients requiring coronary artery graft surgery.
Materials and Methods: In this study, 150 consecutive patients underwent OPCAB by one surgeon. Octopus device used for regional wall stabilization. Vascular control achieved by ethibond loops, occluder, and shunts. Situations such as cardiomegaly, poor ventricular function, advanced age, hemodynamic instability, and small coronary arteries were not considered contraindications to OPCAB.
Results: Of 150 OPCAB cases, 146 (97.3 percent) were completely off-pump. The mean number of grafts per patient was 4.1 (range, 2 to 6). Total 595 distal grafts anastomosed to LAD (140) diagonals (140), right coronary artery (145), left circumflex (164). Thirty-day mortality and myocardial infarction were 0.6 percent and 3.3 percent respectively OPCAB patient experienced lesser postoperative bleeding had shorter stay at surgical intensive care unit and extubated earlier. Conduits used were left internal mammary artery, radial artery and greater saphenous vein.
Conclusion: OPCAB is a safe method for complete revascularization in nearly all patients. The OPCAB patients experience less complications, have shorter hospital stay, absolute contraindication for OPCAB other than severe, diffuse coronary artery disease with poor run-off which is better treated by cardiopulmonary bypass.
Forouzan Nia Skh, Hadadzadeh M, Mirhosseini Sj, Hosseini H, Abdollahi Mh, Forat Yazdi M, Rasti M, Dehghanizadeh H, Ghoreishian Sm,
Volume 68, Issue 9 (12-2010)
Abstract
Background: One of the most important components of coronary
artery bypass graft surgery is need for blood transfusion that increases
morbidity and mortality. The aim of this study was to evaluate the factors
affecting the need for blood transfusion during off pump coronary artery bypass
(OPCAB)
surgery.
Methods: In
this descriptive case control study 923
patients who had undergone OPCAB at Afshar Hospital in Yazd,
Iran, from July 2008 to January 2010
were evaluated. The data was gathered from their records and was analyzed.
Results: 54% of
male and 79% of female patient need
blood transfusion. Mean age in patients needed transfusion was 61.58±11.11
years and in other group was 60.27±10.98
years of the patients that needed transfusion (p= 0.08). 563
(61%) of the patients needed transfusion with the
average of two units. The need for blood transfusion was higher in female
gender (p< 0.0001),
low hematocrit (p< 0.0001),
diabetes (p< 0.001),
hypertension (p< 0.025)
and multiple grafts (p< 0.027).
There were no significant differences in preoperative hemostasis tests,
affection to hyperlipidemia, CVA or
renal failure, antiplatelet drug administration and the application of left internal
mammary artery between the transfusion and non transfusion groups.
Conclusion: In this study preoperative
hematocrit was most important risk factor in transfusion in patients that
underwent OPCAB. Female gender, preoperative
low hematocrit, multiple grafts, diabetes and hypertension increased the rate
of blood transfusion. According to the high prevalence of blood transfusion in OPCAB, considering factors that
affect the transfusion rate is essential.
Forouzan Nia Skh, Mirhosseini Sj, Moshtaghion Sh, Abdollahi Mh, Hosseini H, Dehghanizadeh H, Bani Fateme Sa, Hosseini Sm,
Volume 68, Issue 12 (3-2011)
Abstract
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Background: Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary
Artery Bypass (OPCAB) surgery is essential
for the prevention of pleural and pericardial effusions, cardiac tamponade and
late complications such as constrictive pericarditis. Drainage tubes themselves
may induce some complications which can negatively affect the result of the
surgery. In this study we assessed a new technique for chest drainage following
OPCAB.
Methods: In this clinical trial, 171 patients were
allocated to two groups. In the control group, the drainage technique included
one drain in the left pleural cavity and another in the mediastinum, while in
the case group the drainage technique included one drain in the left plural
and one in the right pleural cavity.
Results: The amount of drainage in the case group was more than the control group (p=0.001).
We found significant reductions in the incidence of arrhythmias in the case
group (p=0.005). While one patient (1.2%)
needed reoperation for bleeding control in the control group, no patients
needed reexploration in the case group (p=0.497).
The duration of hospital (p=0.022) and ICU
(p=0.002) stays was shorter in the case group.
Conclusions: Based
on the results of this study, changing the position of mediastinal drains in
patients undergoing OPCAB surgery and shifting it to
the right pleural cavity, reduces complications, such as arrhythmia and
pericardial effusion, aside from establishing a better drainage.
