Concomitant off-pump coronary artery bypass and non-cardiovascular surgery

Abstract

Background: Reports on concomitant cardiac and non-cardiovascular surgeries have noted disadvantages in the use of extracorporeal circulation. We assessed the results of concomitant off-pump coronary artery bypass (OPCAB) and non-cardiovascular surgery, and compared them with isolated OPCAB results.Methods: Of 2,439 patients who underwent OPCAB between 1999 and 2014, 115 patients underwent concomitant OPCAB and non-cardiovascular surgery. Combined non-cardiovascular diseases included 63 malignant and 52 benign diseases. Concomitant non-cardiovascular surgeries performed were general (n=62), thoracic (n=47), orthopedic (n=3), urologic (n=2) and otolaryngologic surgeries (n=1). Operative results were compared between the OPCAB patients who underwent concomitant non-cardiovascular surgeries (group 1, n=115) and isolated OPCAB patients (group 2, n=2,251). Because preoperative characteristics of the two groups were different, a 1:2 propensity score-matched analysis was performed and operative results of the two matched groups were compared.Results: Operative mortality rates were 0.9% (1/115) in group 1 and 1.0% (22/2,251) in group 2 (P=0.909).Although there were differences in preoperative patient characteristics, postoperative complications, including atrial fibrillation (36.5% vs. 28.8%), perioperative myocardial infarction (MI) (4.3% vs. 5.2%), acute renal failure (1.7% vs. 4.9%), mediastinitis (0.9% vs. 0.8%), bleeding reoperation (0.9% vs. 2.9%), and respiratory complications (2.6% vs. 2.1%), did not show significant differences between the two groups.After a 1:2 propensity score-matched analysis, there were no statistical differences in operative complications between the two groups.Conclusions: Concomitant OPCAB and non-cardiovascular surgeries were not associated with increased mortality and postoperative morbidities when compared with isolated OPCAB.

Dois tipos de treinamento muscular inspiratório sobre a força muscular de pacientes após revascularização do miocárdio: ensaio clínico

“…These complications can lead to an increase in hospital stay, risk of functional decline and increased mortality rate. In this sense, inspiratory muscle training (IMT) appears as a tool for hospital rehabilitation of this population [1][2][3][4][5]. Some intra and postoperative procedures are directly linked to these complications: the median sternotomy, the effects of anesthesia, cardiopulmonary bypass (CPB), use of chest tubes and invasive mechanical ventilation can alter respiratory mechanics [6,7].…”

Combined operation for thymoma with myasthenia gravis and coronary artery disease in an octogenarian

“…The elective combined operation for thymoma with or without MG or non‐thymoma with MG and coronary artery bypass graft has been reported, and recently, the feasibility of OPCABG and thymectomy in elderly MG patients has been also described . Preoperatively, myocardial scintigraphy and, if required, subsequent coronary angiography are carried out in our octogenarian patients.…”