Revascularização do miocárdio sem circulação extracorpórea: resultados imediatos

Lima, Ricardo de Carvalho; Escobar, Mozart; Neto, José Wanderley; Torres, Luís Daniel; Elias, Décio O; Mendonça, José Teles de; Lagreca, Ricardo; Dellassanta, Renato; Granja, Luis Gonzaga; Farías, Mónica; Gama, Hemerson Casado

doi:10.1590/s0102-76381993000300001

Cited by 12 publications

(11 citation statements)

References 10 publications

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“…Observational studies have already suggested similar results to conventional CABG [15]. The effectiveness of off-pump CABG surgery has been demonstrated in patients with multivessel disease [22], or in those with disease in the left coronary artery [16], and in high-risk patients preoperatively as well [17].…”

Section: Discussionmentioning

confidence: 88%

Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Cantero¹,

Almeida²,

Galhardo³

2011

Rev Bras Cir Cardiovasc

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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

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Section: Discussionmentioning

confidence: 88%

Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Cantero¹,

Almeida²,

Galhardo³

2011

Rev Bras Cir Cardiovasc

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“…This experience includes the initial cases, the learning curve, limitation of revascularization of the posterior vessels of the heart and patients operated on with and without cardiac stabilization [14,15]. In this population, there were patients with very different degrees of coronary and systemic diseases (including uni-, bi-and tri-arterial coronary disease), young patients (13 years old) and elderly patients (93 years).…”

Section: Discussionmentioning

confidence: 99%

Surgical results of coronary artery bypass grafting without cardiopulmonary bypass: analysis of 3,410 patients

Lima¹,

Escobar²,

Filho³

et al. 2003

Rev Bras Cir Cardiovasc

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Objective: Over the past few years, great strides have been made in off-pump coronary surgery. This progress is due to a combination of the advances in surgical techniques and the development of instruments that make it possible to perform this procedure in the most varied situations. This is a retrospective study, the purpose of which is to assess our experience with this procedure over the last eleven and a half years. The authors underscore the rapid progress of the method in recent years and report on its indications, contraindications and results.Methods: In the period from August 1991 to December 2003, 3,410 consecutively patients suffering from angina pectoris were submitted to off-pump coronary surgery. Ages ranged from 13 to 93 years, with a mean of 63 ± 12.0 years. Males accounted for 58% of the cases. The angina was rated according to the criteria of the Canadian Cardiovascular Society, 6.1% of the patients being in Class I, 6.8% in Class II, 46.3% in Class III and 40.8% in Class IV.Results: Intraoperative mortality was low (0.4%). Hospital mortality (30 postoperative days) was 2.5%. Mortality and morbidity among the octogenarian patients were extremely low compared with patients operated on with cardiopulmonary bypass (CPB) (2.2% versus 12.6%) (p<0.001). Postoperative complications regarded as nonfatal occurred in 7.6%. In the final year no difference was observed between the number of conduits in the patients operated on with and without CPB [with CPB 2.8 ± 1.2 and without 2.8 ± 0.8 (NS)]. Acute myocardial infarction was the most frequent complication, occurring in 2.7% of the patients. The mean time in the intensive care unit was 22.3 hours.Conclusions: Off-pump coronary surgery, employed as a revascularization technique in patients requiring multiple grafts, is a reproducible procedure, the results of which are similar to those obtained from conventional surgery with CPB. In the present series it was possible to perform coronary artery bypass grafting without CPB in 95% of the patients, thus making all patients with indication for grafting potential candidates for the procedure without CPB.Descriptors: coronary disease, coronary artery bypass grafting; off-pump coronary surgery. Cardiovasc 2003; 18(3): 261-267 EXPERIENCE OF THE SERVICE Rev Bras Cir

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“…After anesthetic induction and graft obtainment 11 , the patients were heparinized with a dose of 2.5 mg/kg. A 2-0 thread stitch fixed to a 3-cm-width cotton band was applied to the pericardial deflexion between the inferior vena cava and the right inferior pulmonary vein 12 for complete exposure of the heart. The distal anastomoses were performed first, and the artery approached was occluded in its proximal portion to the anastomosis with a 4-0 thread stitch.…”

Section: Methodsmentioning

confidence: 99%

Revascularização do miocárdio sem circulação extracorpórea em pacientes acima de 75 anos: análise dos resultados imediatos

Milani¹,

Brofman²,

Varela³

et al. 2005

Arq. Bras. Cardiol.

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ObjectiveTo assess the immediate results of myocardial revascularization surgery without extracorporeal circulation in a group of patients over 75 years of age. December 2003, 193 (121 men and 72 women) Methods From January 2001 to ConclusionThe surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital. Keywords elderly, myocardial revascularization surgery, extracorporeal circulationThe increase in the elderly population in Brazil in recent years has led to a greater number of patients over the age of 70 years requiring myocardial revascularization surgery. However, over the years, advanced age has been considered a risk factor for morbidity and mortality in coronary artery surgeries 1,2 . The recent advances in myocardial revascularization surgeries without extracorporeal circulation, the technique recommended by Buffolo et al 3 and Benetti 4 at the beginning of the 1980s, has aroused interest in this type of surgery, especially in high-risk patients [5][6][7] .We retrospectively analyzed the immediate results of the myocardial revascularization surgery without extracorporeal circulation in patients over the age of 75 years.

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Revascularização do miocárdio sem circulação extracorpórea: resultados imediatos

Cited by 12 publications

References 10 publications

Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Análise dos resultados imediatos da cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Surgical results of coronary artery bypass grafting without cardiopulmonary bypass: analysis of 3,410 patients

Revascularização do miocárdio sem circulação extracorpórea em pacientes acima de 75 anos: análise dos resultados imediatos

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