Off-Pump and On-Pump Coronary Revascularization in Patients With Low Ejection Fraction: A Report From The Society of Thoracic Surgeons National Database

2013 ◽  
Vol 96 (1) ◽  
pp. 83-89 ◽  
Author(s):  
W. Brent Keeling ◽  
Matthew L. Williams ◽  
Mark S. Slaughter ◽  
Yue Zhao ◽  
John D. Puskas
Keyword(s):  
Ejection Fraction ◽  
Coronary Revascularization ◽  
National Database ◽  
Off Pump ◽  
Low Ejection Fraction

Off-pump Coronary Bypass Surgery in Patients with Low Ejection Fraction

2010 ◽  
Vol 5 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Hagen Gorki ◽  
Nirav C. Patel ◽  
Georgia Panagopoulos ◽  
Joan Jennings ◽  
Lognathen Balacumaraswami ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Ejection Fraction ◽  
Bypass Surgery ◽  
Coronary Intervention ◽  
Term Survival ◽  
Off Pump ◽  
Percutaneous Coronary ◽  
Opcab Surgery ◽  
Low Ejection Fraction

Objective Long-term survival after off-pump surgery in patients with low ejection fraction was investigated. Methods Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery. Results The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients. Conclusions OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.

Off-pump Coronary Bypass Surgery in Patients with Low Ejection Fraction

2010 ◽  
Vol 5 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Hagen Gorki ◽  
Nirav C. Patel ◽  
Georgia Panagopoulos ◽  
Joan Jennings ◽  
Lognathen Balacumaraswami ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump ◽  
Low Ejection Fraction

Off-Pump Coronary Bypass Surgery Is Safe in Patients with a Low Ejection Fraction (≤25%)

2010 ◽  
Vol 13 (3) ◽  
pp. E136-E142 ◽  
Author(s):  
Maximilian Y. Emmert ◽  
Lorenz S. Emmert ◽  
Eliana C. Martinez ◽  
Chuen N. Lee ◽  
Theo Kofidis
Keyword(s):  
Ejection Fraction ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump ◽  
Low Ejection Fraction

Is low ejection fraction safe for off-pump coronary bypass operation?

2000 ◽  
Vol 70 (3) ◽  
pp. 1021-1025 ◽  
Author(s):  
Kit V Arom ◽  
Thomas F Flavin ◽  
Robert W Emery ◽  
Vibhu R Kshettry ◽  
Rebecca J Petersen ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Coronary Bypass ◽  
Bypass Operation ◽  
Off Pump ◽  
Coronary Bypass Operation ◽  
Low Ejection Fraction

scholarly journals ICU Stay in Patients with Low Ejection Fraction Undergoing Cardiac Revascularization: Comparison of On-Pump Versus Off-Pump Coronary Artery Bypass Grafting

2021 ◽  
Vol 15 (8) ◽  
pp. 2494-2496
Author(s):  
Muhammad Bilal ◽  
Ahmad Fawad ◽  
Syed Mumtaz Anwar Shah
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ejection Fraction ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Off Pump ◽  
Icu Stay ◽  
Pump Coronary Artery Bypass ◽  
Cardiac Revascularization ◽  
Low Ejection Fraction

Background: Coronary artery bypass graft (CABG) surgery can result in serious complications for the patients. It is being currently performed with cardiopulmonary bypass with cardiac arrest in 80% of the cases across the world. There have debate in the past regarding the cardiac revascularization via CABG approaches. Aim: The aim of this study is to study the difference in the patient’s ICU stay who have low ejection fraction and are undergoing cardiac revascularization between off pump and on pump coronary artery bypass grafting. Methodology: A sample size of 60 patients has been taken in the study with 30 patients' in the on-pump surgery group and 30 patients' in the off-pump surgery group. The data has been collected from department of Cardiac Srugery AFIC/NIHD, Rawalpindi. Results and Conclusion: The study concludes that the on-pump CABG patients tend to have shorter ICU stay than the off-pump CABG patients who have low ejection fraction and are undergoing cardiac revascularization. Therefore, on-pump treatment is recommended in the study. Keywords: Off pump, on pump, coronary artery bypass grafting, ICU stay, low ejection fraction, cardiac revascularization

Beating Heart Revascularization with Minimal Extracorporeal Circulation in Patients with a Poor Ejection Fraction

2005 ◽  
Vol 6 (1) ◽  
pp. 19 ◽  
Author(s):  
Thierry A. Folliguet ◽  
Fran�ois Philippe ◽  
Fabrice Larrazet ◽  
Alain Dibie ◽  
Daniel Czitrom ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ejection Fraction ◽  
Extracorporeal Circulation ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Beating Heart ◽  
Bypass Grafting ◽  
The Mean ◽  
Low Ejection Fraction

<P>Background: Coronary artery bypass grafting with cardioplegia in patients with a low ejection fraction carries a risk of myocardial ischemia. Beating heart surgery is associated with hemodynamic changes when the heart is manipulated. We assessed an alternative: minimal extracorporeal circulation for coronary artery bypass grafting on a beating heart in patients with a poor ejection fraction. </P><P>Methods: From January 2000 to January 2002, 50 patients with an ejection fraction of less than 35%, who represented 10% of all patients undergoing coronary artery procedures, underwent revascularization on a beating heart with assistance. We used a closed cardiopulmonary bypass system with a centrifugal pump without reservoir, and the surgical strategy was modified to avoid aortic cross-clamping and to decrease bypass time. </P><P>Results: The main preoperative characteristics were: age (mean � SD) of 64 � 11.2 years (range, 41-87 years), 35 male patients (70%), mean left ejection fraction of 24.8% � 11.2%, and a mean EuroSCORE of 5.8 � 2.7. Revascularizations of 146 distal anastomoses (2.9 � 0.7 grafts/patient) were completed. Twelve percent were double bypass, 86% were triple bypasses, and 2% were quadruple bypasses; the mean bypass time was 64.2 � 26.2 minutes. The mean graft number was 2.9, and the hospital mortality was 2%. Perioperative hematocrit levels were 30.1%, and 26% of patients received transfusions. Postoperative data showed a median extubation time of 9 hours, a median intensive care unit stay of 48 hours, and a hospital stay of 8 � 2 days. Postoperative complications included inotropic support (14%), cerebrovascular events (2%), reoperation for homeostasis (4%), delayed sternal closure (2%), and mediastinitis (2%). Peak troponin Ic level remained a low 2.4 � 1.9 3g/mL. Follow-up at 6 months was complete with 1 late mortality and with a mean ejection fraction of 30.5% � 10.8% for the survivors. Conclusions: Coronary revascularization on a beating heart with extracorporeal assistance can be done in patients with a low ejection fraction. It avoids the myocardial injury associated with aortic cross-clamping and allows safe and complete coronary revascularization.</P>

scholarly journals Off-pump myocardial revascularization (OPCAB) in patients with post-infarction unstable angina, low ejection fraction and renal dysfunction

2005 ◽  
Vol 52 (3) ◽  
pp. 45-48
Author(s):  
S. Kacar ◽  
M. Stanic ◽  
S. Putnik ◽  
S. Pejkic ◽  
Lazar Davidovic ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Unstable Angina ◽  
Renal Dysfunction ◽  
Myocardial Function ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Postoperative Hospital Stay ◽  
Off Pump ◽  
Clinical Centre ◽  
Low Ejection Fraction

The purpose of this study is to present our experience in off-pump myocardial revascularization in patients with post-infarction unstable angina, left ventricular low ejection fraction and renal dysfunction. Material and methods. From January 1998. until march 2002., at the Institute for Cardiovascular Diseases in Clinical Centre of Serbia, we have operated 20 patients with post infarction unstable angina, echocardiographicaly proved low ejection fraction (less than 30%) and renal dysfunction (Serum Creatinin 150 micrograms per liter) using this method. All patients were male and they were between 52 and 79 years old. Preoperative characteristics, surgical treatment and postoperative course are presented. Results. There was no hospital mortality, as well as important morbidity. There was no worsening of the renal and myocardial function. Postoperative ICU stay was from 1 to 2 days. Postoperative hospital stay was between 3 and 7 days. Conclusion. Off-pump myocardial revascularization is safe and effective procedure in all patients with left ventricular low ejection fraction and renal dysfunction.

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