Multivessel off-pump revascularization in octogenarians: early and midterm outcomes

Beauford, Robert B.; Goldstein, Daniel J.; Sardari, Frederic; Karanam, Ravindra; Luk, Brandon; Prendergast, Thomas; Burns, Paul; Garland, Patricia; Chen, Chunguang; Patafio, O.; Saunders, Craig R.

doi:10.1016/s0003-4975(03)00014-6

Cited by 49 publications

(24 citation statements)

References 22 publications

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“…As investigators continue to elucidate the appropriate role for OPCAB surgery, some authors have shown that higher-risk patients, including the elderly, stand to benefit most from avoiding the cardiopulmonary bypass (CPB) circuit (4,(15)(16)(17). The elderly may be particularly at risk for higher morbidity after CPB due to decreased physiological reserves and greater incidences of comorbid illnesses, which may impair their response to the post-CPB inflammatory syndrome.…”

Section: Clinical Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

Nagpal¹,

Bhatnagar²,

Cutrara³

et al. 2006

Canadian Journal of Cardiology

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Section: Clinical Studiesmentioning

confidence: 99%

“…The consequent reluctance to operate on these 'old old' people has created a self-fulfilling prophecy wherein these older patients are referred for surgery only when their disease is highly advanced, thereby increasing morbidity and mortality rates (2). Nevertheless, surgical outcomes in this age group have been encouraging (3)(4)(5)(6)(7).…”

mentioning

confidence: 99%

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

Nagpal¹,

Bhatnagar²,

Cutrara³

et al. 2006

Canadian Journal of Cardiology

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“…No se ha demostrado un beneficio en la mortalidad en pacientes de bajo riesgo, pero existirían beneficios del uso de esta técnica en algunos grupos, tales como aquellos con alto riesgo de ac-cidentes neurológicos, portadores de enfermedad ateroesclerótica severa de la aorta, insuficiencia renal, enfermedad pulmonar crónica, edad avanzada y enfermedad vascular periférica 8,[18][19][20][21] .…”

Section: Discussionunclassified

Resultados inmediatos y a mediano plazo de la cirugía coronaria sin circulación extracorpórea: Experience in 220 patients

González

Stockins

et al. 2013

Rev. méd. Chile

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“…The presence of left ventricular dysfunction and cardiac failure in the postoperative period of CABG has been considered one of most important independent predictive factors of surgical mortality [2][3][4][5] , with an association between the severity of the left ventricular dysfunction and risk of complications (4% to 10% for moderate to severe ventricular dysfunction) 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies show a decrease in complications when CABG is performed without ECC 4,5 . The prognostic evaluation of the patients undergoing CABG through pre-operative clinical parameters, present well-defined usefulness and understanding 6,7 .…”

Section: Arq Bras Cardiol 2006; 87 : 410-415mentioning

confidence: 99%

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

Azzolin¹,

Castro²,

Feier³

et al. 2006

Arq. Bras. Cardiol.

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objective: Myocardial Performance Index (MPI) obtained by Doppler echocardiography for the non-geometrical evaluation of systolic and diastolic function has been described as a method for prognostic evaluation in patients with acute myocardial infarction (AMI). Using the same condition, the objective of this study was to evaluate the predictive value of MPI for cardiovascular complications in patients at low risk during the postoperative period of CABG. Methods:Eighty patients submitted to CABG with adequate left ventricular function in the preoperative period were studied, with MPI measured during the first hours postoperatively. Patients were followed until hospital discharge. Statistical analysis included Chi-Square test, Student t test, Mann-Whitney test, and estimation of relative risks with 95% confidence intervals, sensitivity and specificity plus a ROC curve. results:The data were evaluated by two independent observers blinded to the clinical data with non-significant intra and interobserver variability. MPI=0.43 was found as the cutoff point, considering patients with a higher probability of postoperative events those who had MPI above 0.43. The relevant events for analysis were AMI (RR 0.87 ci 0.21-3.65), atrial fibrillation (RR 0.65 ci 0.24 -1.76), other arrhythmias (RR 1.51 ci 0.36-6.33), LV dysfunction (RR 1.74 ci 0.32-9.88), with no association between patients with MPI>0.43 and the occurrence of these events. conclusion:No association was found between MPI and cardiovascular complications and longer hospital stay in this group of patients, and this index was considered not adequate as an isolated predictive method.Key words: Coronary artery bypass graft, low risk, morbidity, myocardial performance index (MPI) and prognostic outcome.The post-surgical morbimortality of coronary artery bypass graft (CABG) surgery is of great interest, resulting in several protocols of post-operative management and risk models aiming at decreasing cardiovascular complications 1 .The presence of left ventricular dysfunction and cardiac failure in the postoperative period of CABG has been considered one of most important independent predictive factors of surgical mortality [2][3][4][5] , with an association between the severity of the left ventricular dysfunction and risk of complications (4% to 10% for moderate to severe ventricular dysfunction) 3 .Cardiac surgery complications in patients with adequate left ventricular function in the pre-operative period have a low prevalence 2 ; therefore, they are hardly studied. In this group, the identification of alterations in the overall function of the left ventricle in the immediate post-operative period would allow early interventions, resulting in lower surgical morbimortality 6,7 .Non-invasive measurements of time intervals used for the assessment of the systolic and diastolic functions were proposed by Mancini 8 through phonomechanocardiography and reintroduced by Tei et al 9 in 1995 and showed to be easily obtained by conventional Doppler, with time intervals, combining...

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Multivessel off-pump revascularization in octogenarians: early and midterm outcomes

Cited by 49 publications

References 22 publications

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

Resultados inmediatos y a mediano plazo de la cirugía coronaria sin circulación extracorpórea: Experience in 220 patients

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

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