Title: Patient's outcomes after conversion from off-pump coronary artery bypass to on-pump coronary artery bypass grafting
Abstract: Objective:analyse the outcomes and safety of conversion in off-pump coronary artery bypass(OPCABG),and propose prevention strategies for achieving better surgical results.Methods:93 conversion patients from April 2010 to May 2013 were studied.Among them 80 cases were emergent conversion,13cases were selective conversion.Data of mechanical ventilation time,ICU and hospital stay,utilization of circulatory assisted device,operative mortality and morbidity rates were reviewed.Results:compare to selective conversion group,emergent converted patients have long mechanical ventilation time 18(13.5,33.5) vs.40.5(19,120.3) hours,P0.05,more ICU treatment time〔48(21.5,49) vs.76(27,142.3) hours,P0.05) 〕and hospital stay〔18(14.5,21.5) vs.18(11,23.8) days,P0.01) 〕,increased peri-operative myocardial infarction rates(7.7% vs.38.8%,P0.05),higher rates of intra aortic balloon counter pulsation(IABP)(15.4% vs.87.5%,P0.01) and extracorporeal membrane oxygenator(ECMO) supporting(zero vs.26.3%,P0.05).Operative mortality was significantly higher in emergent conversion group(zero vs.37.5%,P0.01).Conclusion:emergent OPCABG conversion are associated with worse adverse outcomes and higher operative mortalities,a prevention protocol including OPCABG surgeon training,preoperative risk factors evaluation,intraoperative decision making and surgical team cooperation should be emphasized during daily OPCABG practice.
Publication Year: 2013
Publication Date: 2013-01-01
Language: en
Type: article
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