Objective: The objective of this study is to compare the immediate results of patients undergoing on-pump versus off-pump coronary artery bypass graft (CABG) surgery.Methods: From January 2007 to January 2009, 177 patients underwent CABG. Of these, 92 underwent off-pump CABG and 85 on-pump CABG. We evaluated the demographics, preoperative risk factors, preoperative functional class, and risk assessment by the EuroSCORE. A comparison between both groups regarding the postoperative evolution was carried out as well.Results: The mean number of grafts per patient was 2.48 ± 0.43 in the off-pump group versus 2.90 ± 0.59 in the onpump group. In the off-pump group, 97.8% of patients received an internal thoracic artery graft, while in the onpump group, the percentage was 94.1% (P = 0.03). The rate of complete revascularization was similar in both groups. In the off-pump group, the circumflex artery (circumflex branch of the left coronary artery) was revascularized in 48.9% of the patients versus 68.2% of the patients in the onpump group (P = 0.01). Hospital mortality was 4.3% for offpump CABG and 4.7% for on-pump CABG (P = 0.92). The off-pump group had fewer complications in relation to perioperative myocardial infarction (P = 0.02) and use of intra-aortic balloon pump (P = 0.01).Conclusion: The off-pump CABG is a safe procedure with hospital mortality similar to that observed in on-pump CABG, with lower rates of complications and less need for intra-aortic balloon. Rev Bras Cir Cardiovasc 2012;27(1):38-44
Descriptors
The heat shock proteins are endogenous proteins with the ability to act as
molecular chaperones. Methods that provide cell protection by way of some damage
can positively influence the results of surgery. The present review summarizes
current knowledge concerning the cardioprotective role of the heat shock
proteins as occurs in heart damage, including relevant information about the
stresses that regulate the expression of these proteins and their potential role
as biomarkers of heart disease.
Objetive
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB)
improved symptoms and increased survival and quality of life in patients
with coronary artery disease. However, it should be the main cause of a
complex organic systemic inflammatory response that greatly contributes to
several postoperative adverse effects.
Methods
We aimed to evaluate heat-shock protein 70 (HSP 70) expression as a
morbimortality predictor in patients with preserved ventricular function
undergoing coronary artery bypass grafting (CABG) with cardiopulmonary
bypass (CPB) and to determine their association with the lactate as a marker
of tissue hypoperfusion and the EuroSCORE risk score. This is a prospective,
observational study including 46 patients and occurring between May and July
2016. Patients without ventricular dysfunction undergoing myocardial
revascularization with extracorporeal circulation were included. They were
divided into (1) complicated and (2) uncomplicated postoperative evolution
groups. EuroSCORE, lactate levels, and HSP 70 expression and their
correlations were determined.
Results
Statistical analysis showed that the group with complicated evolution had
higher EuroSCORE values than the other group. HSP 70 protein levels were
significantly increased in the group with uncomplicated evolution and showed
similar results. According to our results, HSP family proteins may be
independent predictors of uncomplicated evolution in patients without
ventricular dysfunction undergoing CABG with CPB.
Conclusion
HSP 70 should be a good discriminator and protection marker for complications
in cardiac surgery.
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