Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery

Cueva, Clotário; M, Rocha; Mendes, Carlos Maurício Cardeal; Freitas, Luiz Antônio Rodrigues de; Baucia, José Augusto; Badaró, Roberto

doi:10.5935/1678-9741.20130038

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…This could be explained by the increased ischemic burden exerted by on-pump beating CABG which therefore derive in diastolic dysfunction and pulmonary edema. Previous data has shown similar ultrastructural abnormalities in patients who underwent beating and arrested heart procedures [ 17 ] . Nonetheless, even though logistic regression aims at correcting baseline differences, patients with AXC were less sicker and this could contribute to our findings.…”

Section: Discussionmentioning

confidence: 57%

On-Pump Beating/Non-Beating CABG in Stable Angina Have Similar Outcomes

Dayan¹,

Paganini²,

Marichal³

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveOn pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left ventricular function. Our aim was to study the postoperative results using both techniques in this group of patients.MethodsOne thousand one hundred and forty-five patients with stable angina underwent on-pump isolated CABG in Uruguay from 2011 to 2015. Patients were grouped into beating/non-beating CABG. Operative mortality and long-term survival were evaluated as primary outcome. Logistic regression analysis was performed to define the predictive role of aortic cross clamp (AXC) on prolonged inotropic support, ventilator support and intraoperative glycemia.ResultsAmong the included patients, 988 underwent aortic cross clamp. No differences were found in operative mortality, stroke and long-term survival among both groups. Patients without AXC showed higher intraoperative values of glycemia and higher incidence of postoperative prolonged mechanical ventilator support (7.6% vs. 2.4%; P=0.001). The need for prolonged inotropic support was lower in this group of patients (27.4% vs. 49.5%; P<0.001).ConclusionOn-pump beating CABG has similar operative mortality and long-term survival compared with conventional AXC. Higher intraoperative glycemia and higher incidence for prolonged mechanical ventilator is associated with on-pump beating CABG. On the contrary, higher incidence for prolonged inotropic support is associated with AXC. Taking these factors into consideration, both techniques are safe and allow the surgeon to choose the most comfortable option.

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Section: Discussionmentioning

confidence: 57%