OBJECTIVES: Atherosclerosis has been identified as a risk factor for both morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG). To investigate outcomes following CABG for severe atherosclerosis, and to determine whether different surgical techniques can reduce the risk of neurologic events in these patients. METHODS: We studied 225 consecutive patients who underwent elective isolated CABG. Routine preoperative and intraoperative examinations identified patients with severe atherosclerosis. We compared the outcomes between patients with (group A; 42 ceses) and those without (group N; 183 cases) severe atherosclerosis. RESULTS: 36 patients (85.7%) in group A and 176 (96.2%) in group N underwent off-pump coronary artery bypass (OPCAB); 6 (14.3%) in group A and 7 (3.8%) in group N underwent on-pump beating CABG. Three patients in group A suffered deep sternal infection (7.1%), and one suffered stroke (2.4%) compared with none in group N. No cerebral infarction or neurologic events occurred in patients who underwent OPCAB (n = 212, 94.2%). CONCLUSIONS: Prevalence of complications was significantly greater among patients with severe atherosclerotic disease who underwent OPCAB than in those without atherosclerotic disease. Careful selection of surgical strategies can prevent perioperative stroke and reduce mortality.
OBJECTIVES:Atherosclerosis has been identified as a risk factor for both morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG). To investigate outcomes following CABG for severe atherosclerosis, and to determine whether different surgical techniques can reduce the risk of neurologic events in these patients. METHODS: We studied 225 consecutive patients who underwent elective isolated CABG. Routine preoperative and intraoperative examinations identified patients with severe atherosclerosis. We compared the outcomes between patients with (group A; 42 ceses) and those without (group N; 183 cases) severe atherosclerosis. RESULTS: 36 patients (85.7%) in group A and 176 (96.2%) in group N underwent off-pump coronary artery bypass (OPCAB); 6 (14.3%) in group A and 7 (3.8%) in group N underwent on-pump beating CABG. Three patients in group A suffered deep sternal infection (7.1%), and one suffered stroke (2.4%) compared with none in group N. No cerebral infarction or neurologic events occurred in patients who underwent OPCAB (n = 212, 94.2%). CONCLUSIONS: Prevalence of complications was significantly greater among patients with severe atherosclerotic disease who underwent OPCAB than in those without atherosclerotic disease. Careful selection of surgical strategies can prevent perioperative stroke and reduce mortality.
Authors: Kevin A Bybee; Brian D Powell; Uma Valeti; A Gabriela Rosales; Stephen L Kopecky; Charles Mullany; R Scott Wright Journal: Circulation Date: 2005-08-30 Impact factor: 29.690
Authors: V G Dávila-Román; S F Murphy; N J Nickerson; N T Kouchoukos; K B Schechtman; B Barzilai Journal: J Am Coll Cardiol Date: 1999-04 Impact factor: 24.094
Authors: Antonio M Calafiore; Michele Di Mauro; Giovanni Teodori; Gabriele Di Giammarco; Sergio Cirmeni; Marco Contini; Angela L Iacò; Marco Pano Journal: Ann Thorac Surg Date: 2002-05 Impact factor: 4.330
Authors: Sebastian Wiberg; Mikkel Schoos; Henrik Sillesen; Carsten Thomsen; Christian Hassager; Daniel Steinbrüchel; Torben Schroeder; Peter Clemmensen; Henning Kelbæk Journal: Ann Vasc Dis Date: 2015-03-09