Off-pump versus conventional coronary artery bypass grafting for coronary artery disease

Coronary Artery Disease (CAD) atau Penyakit Jantung Koroner (PJK) merupakan suatu gangguan fungsi jantung yang disebabkan karena otot miokard kekurangan suplai darah akibat adanya penyempitan dan tersumbatnya pembuluh darah jantung. Kondisi ini dapat mengakibatkan perubahan pada berbagai aspek, baik fisik, psikologis, maupun sosial yang berakibat pada penurunan kapasitas fungsional dan kenyamanan. Prevalensi pasien dengan gangguan sistem kardiovaskular semakin meningkat. Perawat diharapkan memiliki kontribusi dalam penanganan pasien dengan gangguan sistem kardiovaskular dengan melakukan penerapan dan pendalaman dengan pendekatan Model Adaptasi Roy (MAR). Peran sebagai pemberi asuhan diterapkan pada seorang laki-laki berusia 70 tahun dengan CAD 3VD EF 52% PRE CABG X3 OFF PUMP. Kata Kunci: Model Adaptasi Roy, CAD, CABG

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Resource Utilization in Off-Pump versus Conventional Coronary Artery Bypass Grafting in a Community Hospital: A Comparative Analysis Using Propensity Scoring

The Heart Surgery Forum ◽

10.1532/hsf98.201011115 ◽

2011 ◽

Vol 14 (2) ◽

pp. 81 ◽

Cited By ~ 1

Author(s):

Scot C. Schultz ◽

Scott Woodward ◽

George Ebra

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Hospital Mortality ◽

Coronary Artery Bypass ◽

Resource Use ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Off Pump ◽

Conventional Coronary Artery Bypass

Background: At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) revascularization.Methods: From January 2000 through December 2008, 1003 patients underwent OPCAB grafting by a single surgeon (S.C.S.). Data were prospectively collected, entered into a Society of Thoracic Surgeons adult cardiac surgery database, and analyzed retrospectively. We used propensity-matching techniques to match this cohort to a group of 1003 patients who underwent CCAB.Results: The hospital mortality rate was lower for the OPCAB patients than for the CCAB patients: 2.0% (20/1003) versus 2.8% (28/1003). Predictors of hospital mortality for the entire cohort included age (P = .001), cardiogenic shock (P = .001), congestive heart failure (P = .019), history of myocardial infarction (P = .001), and reoperation (P = .007). The overall incidence of morbidity was lower for the OPCAB patients (reoperation for bleeding, P = .011; prolonged ventilation, P = .035; stroke, P = .045; cardiac arrest, P = .004). OPCAB patients experienced significantly reduced procedure times (P = .001), postoperative ventilation times (P = .035), post-operative lengths of stay (P = .035), and blood product use (intraoperative, P = .001; postoperative, P = .001).Conclusion: These outcomes clearly demonstrate that OPCAB is a safe and effective procedure for myocardial revascularization. This retrospective, nonrandomized observational study has shown that the patients who underwent OPCAB had reduced morbidity and mortality, as well as decreased resource use, compared with those who underwent CCAB.

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Distribution of Thoracic Aortic Calcifications in Patients Undergoing Coronary Artery Bypass Grafting

Aorta ◽

10.12945/j.aorta.2017.17.035 ◽

2017 ◽

Vol 05 (05) ◽

pp. 132-138 ◽

Cited By ~ 3

Author(s):

Adem Diken ◽

Adnan Yalçınkaya ◽

Sertan Özyalçın

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Classification System ◽

Artery Bypass ◽

Ascending Aorta ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Artery Disease

Background: In procedures involving surgical maneuvers such as cannulation, clamping, or proximal anastomosis where aortic manipulation is inevitable, a preliminary assessment of atherosclerotic plaques bears clinical significance. In the present study, our aim was to evaluate the frequency and distribution of aortic calcifications in patients undergoing coronary artery bypass grafting (CABG) surgery to propose a morphological classification system. Methods: A total of 443 consecutive patients with coronary artery disease were included in this study. Preoperative non-contrast enhanced computed tomography images, in-hospital follow-up data, and patient characteristics were retrospectively evaluated. Results: Whereas 33% of patients had no calcifications at any site in the aorta, 7.9%, 75.4%, and 16.7% had calcifications in the ascending aorta, aortic arch, and descending aorta, respectively. Focal small calcifications were the most common type of lesions in the ascending aorta (3.9%), whereas 9 patients (1.4%) had porcelain ascending aorta. We defined four types of patients with increasing severity and extent of calcifications. Conclusions: Based on the frequency and distribution of calcifications in the thoracic aorta, we propose a classification system from least to most severe for coronary artery disease patients who are candidates for CABG.

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