Levosimendan administration is not associated with increased risk of bleeding and blood transfusion requirement in patients undergoing off-pump coronary artery bypass grafting: a retrospective study from single center

Background: Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. However, Whether LEVO is associated with postoperative bleeding and blood transfusion in cardiac surgical patients is controversial. Therefore, the current study was designed to investigate the impact of LEVO administration on bleeding and blood transfusion requirement in off-pump coronary artery bypass grafting (OPCAB) patients. Methods: In a retrospective analysis, a total of 292 patients, aged 40–87 years, undergoing elective OPCAB between January 2019 and July 2019, were divided into LEVO group ( n = 151) and Control group ( n = 141). Patients in LEVO group continuously received LEVO at a rate of 0.1–0.2 μg kg−1 min−1 after anesthesia induction until 24 hours after OPCAB or patients in Control group received no LEVO. The primary outcome was postoperative chest drainage volume. The secondary outcomes were reoperation for postoperative bleeding, transfusion requirement of red blood cells (RBCs), fresh frozen plasma (FFP) and platelet concentrate (PC), etc. Comparisons of two groups were performed with the Student’s t-test or Wilcoxon-Mann-Whitney test. Results: There was no significant difference with respect to chest drainage volume ((956.29 ± 555.45) ml vs (1003.19 ± 572.25) ml, p = 0.478) and the incidence of reoperation for postoperative bleeding (1.32% vs 1.42%, p = 0.945) between LEVO group and Control group. The transfusion incidence and volume of allogeneic RBCs, FFP, and PC were comparable between two groups. Conclusions: LEVO administration was neither associated with more postoperative blood loss nor increased allogeneic blood transfusion requirement in OPCAB patients.

Download Full-text

Comparison of the Effects of Ringer’s Lactate and 6% Hydroxyethyl Starch 130/0.4 on Blood Loss and Need for Blood Transfusion After Off-Pump Coronary Artery Bypass Graft Cardiac Surgery

Cureus ◽

10.7759/cureus.16049 ◽

2021 ◽

Author(s):

Roshani Manwani ◽

Neha Gupta ◽

Shilpa Kanakam ◽

Minal Vora ◽

Krishnan Bhaskaran

Keyword(s):

Cardiac Surgery ◽

Coronary Artery ◽

Blood Transfusion ◽

Blood Loss ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Off Pump ◽

Ringer’S Lactate ◽

Pump Coronary Artery Bypass

Download Full-text

Effects of preoperative antiplatelet therapy on postoperative bleeding using thromboelastography in off-pump coronary artery bypass grafting

European Journal of Anaesthesiology ◽

10.1097/00003643-200605001-00095 ◽

2006 ◽

Vol 23 (Supplement 38) ◽

pp. 33

Author(s):

H. J. Kwak ◽

J. Y. Kim ◽

W. S. Jung ◽

Y. W. Hong ◽

Y. L. Kwak

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Antiplatelet Therapy ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Off Pump ◽

Pump Coronary Artery Bypass

Download Full-text

Prophylactic Application of an Intra-Aortic Balloon Pump in High-Risk Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

Cardiology ◽

10.1159/000377720 ◽

2015 ◽

Vol 131 (2) ◽

pp. 109-115 ◽

Cited By ~ 11

Author(s):

WenJun Ding ◽

Qiang Ji ◽

Qiang Wei ◽

YunQing Shi ◽

RunHua Ma ◽

...

Keyword(s):

High Risk ◽

Artery Bypass ◽

Control Group ◽

Bypass Grafting ◽

Surgical Mortality ◽

Low Cardiac Output ◽

Off Pump ◽

High Risk Patients ◽

Risk Patients ◽

Pump Coronary Artery Bypass

Background: An intra-aortic balloon pump (IABP) is the most commonly used circulatory assist device in cardiac surgery. We hypothesized that prophylactic application of an IABP improves early clinical outcome of high-risk patients undergoing scheduled off-pump coronary artery bypass grafting (OPCABG). Methods: From January 2010 to December 2013, hemodynamically stable, high-risk patients undergoing scheduled OPCABG with preincision use of an IABP were recruited to the IABP group. Using the propensity score-matching method, every patient in the IABP group was matched with another patient (the control group) with a similar propensity score who received an IABP on an as-needed basis during or after OPCABG. Surgical mortality and major morbidity rates were compared between groups. Results: A total of 116 patient pairs were included in this study. In patients in the IABP group, postoperative low cardiac output and respiratory as well as renal failure were less frequent, intensive care unit stay was shorter, and surgical mortality was lower compared to patients in the control group. In multivariate logistic regression, timing of IABP implantation, as an independent risk factor, was associated with postoperative low cardiac output (OR = 2.02, 95% CI 1.28-5.76), respiratory failure (OR = 1.86, 95% CI 1.19-4.27), renal failure (OR = 2.96, 95% CI 1.51-6.63) and surgical mortality (OR = 2.45, 95% CI 1.42-6.07). Conclusions: Prophylactic application of an IABP improves postoperative cardiac performance, reduces respiratory and renal complications, and consequently lowers surgical mortality in high-risk patients undergoing scheduled OPCABG.

Download Full-text

Effect of Tranexamic Acid on Transfusion Requirement in Dual Antiplatelet-Treated Anemic Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

Circulation Journal ◽

10.1253/circj.cj-11-0811 ◽

2012 ◽

Vol 76 (1) ◽

pp. 96-101 ◽

Cited By ~ 12

Author(s):

So Woon Ahn ◽

Jae Kwang Shim ◽

Young Nam Youn ◽

Jong Wook Song ◽

So Young Yang ◽

...

Keyword(s):

Coronary Artery ◽

Tranexamic Acid ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Transfusion Requirement ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Off Pump ◽

Pump Coronary Artery Bypass

Download Full-text

Clopidogrel Responsiveness Regardless of the Discontinuation Date Predicts Increased Blood Loss and Transfusion Requirement After Off-Pump Coronary Artery Bypass Graft Surgery

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2010.03.108 ◽

2010 ◽

Vol 56 (24) ◽

pp. 1994-2002 ◽

Cited By ~ 87

Author(s):

Young-Lan Kwak ◽

Jong-Chan Kim ◽

Yong-Seon Choi ◽

Kyung-Jong Yoo ◽

Young Song ◽

...

Keyword(s):

Coronary Artery ◽

Blood Loss ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Transfusion Requirement ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Off Pump ◽

Pump Coronary Artery Bypass

Download Full-text

Risk factors of atrial fibrillation following off-pump coronary artery bypass graft surgery: predictive value of C-reactive protein and transfusion requirement

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2009.05.003 ◽

2009 ◽

Vol 36 (5) ◽

pp. 838-843 ◽

Cited By ~ 21

Author(s):

Yong Seon Choi ◽

Jae Kwang Shim ◽

Seong Wook Hong ◽

Dae Hee Kim ◽

Jong Chan Kim ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Transfusion Requirement ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

C Reactive Protein ◽

Off Pump ◽

Reactive Protein ◽

Pump Coronary Artery Bypass

Download Full-text

158 Effect of Preoperative Continuation of Aspirin on Postoperative Bleeding After Off-Pump Coronary Artery Bypass Grafting (OPCABG)

British Journal of Surgery ◽

10.1093/bjs/znab259.233 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

M I S Al-Manzo ◽

S Biswas ◽

S Das Gupta ◽

Md.Z Rahman ◽

B Basak ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Chest Tube ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Bypass Grafting ◽

Off Pump ◽

Significant Difference ◽

Pump Coronary Artery Bypass

Abstract Background Despite ample evidence of continued preoperative aspirin to improve outcomes in coronary artery bypass surgery, practice for routine continued preoperative aspirin use is still inconsistent due to concern for increased postoperative bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on postoperative bleeding after off-pump coronary artery bypass grafting (OPCABG). Method This cohort study involved patients (n = 74) who underwent OPCABG at a single center between August 2017 to January 2018. After considering the inclusion and exclusion criteria, they were divided into two groups: one (n = 37) received tablet Aspirin 75mg till the day of surgery and for the other group (n = 37) aspirin was stopped 5 days before surgery. Postoperative bleeding was recorded in both groups. After considering preoperative, intraoperative, and postoperative variables statistical analysis was done. Results There was no significant difference between the two groups concerning preoperative and peroperative variables. No significant difference was also observed between the two groups in chest tube drainage at 1sthour, 2ndhour, 3rdhour, 24thhour, next 24 hours (at 48th hour), and next 24 hours (at 72nd hour) (p = 0.845, 0.126, 0.568, 0.478, 0.342 and 0.717 respectively). No significant difference was seen in the transfusion requirement of blood and fresh frozen plasma (FFP). Conclusions Continuation of preoperative aspirin till the day of surgery is not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of blood and FFP.

Download Full-text

Off-pump myocardial revascularization using the octopus tissue stabilizer system

Medicinski pregled ◽

10.2298/mpns0302080m ◽

2003 ◽

Vol 56 (1-2) ◽

pp. 80-84 ◽

Cited By ~ 1

Author(s):

Predrag Milojevic ◽

Vojislava Neskovic ◽

Dragos Stojanovic ◽

Miroslav Jakovljevic ◽

Sava Nenic ◽

...

Keyword(s):

Coronary Artery ◽

Heart Surgery ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Open Heart Surgery ◽

Myocardial Revascularization ◽

Arterial Grafts ◽

Off Pump ◽

Coronary Artery Revascularization ◽

Pump Coronary Artery Bypass

Off-pump coronary artery bypass surgery (OPCAB) has changed the approach to contemporary coronary surgery. Development of new surgical devices and techniques has reduced morbidity and mortality during off-pump surgery. From March 2000 - April 2002, a total of 136 patients underwent open heart surgery using off-pump technique and fast-track anesthesia at Dedinje Cardiovascular Institute. Octopus Medtronic coronary stabilizer was used for stabilization of targeted vessel. Arterial grafts were used 169 times and saphenous vein 69 times. Average number of anastomoses was 1,830,73 per patient. One patient (0.74%) died. Three patients (2.21%) underwent surgery revision due to postoperative bleeding and one (0.74%) because of graft dysfunction Perioperative myocardial infarction was registered 2 times (1.47%) pneumothorax 3 times (2.21%), postoperative arrhythmias 11 times (8.09%) transitory ischemic attack once (0.74%) and deep wound infection once (0.74%). Twelve patients (8.82%) required prolonged inotropic support Angiographies early revealed patent grafts in 8 patients (5.88%). OPCAB is a safe and effective alternative approach to coronary artery revascularization Use of coronary stabilizer has improved the safety and quality of OPCAB surgery.

Download Full-text