scholarly journals Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery

2017 ◽  
Vol 147 (2728) ◽  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Life Expectancy ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Excellent Outcome

Minimally invasive versus conventional extracorporeal circulation circuits in patients undergoing coronary artery bypass surgery: a propensity-matched analysis

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Shekhar Saha ◽  
Sam Varghese ◽  
Mike Herr ◽  
Marcus Leistner ◽  
Christian Ulrich ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Circulation System ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Objectives: Minimally invasive extracorporeal circulation circuits provide several advantages compared to conventional extracorporeal circulation circuits. We compared the results of a minimally invasive extracorporeal circulation system with those of conventional extracorporeal circulation system, in patients undergoing isolated coronary artery bypass grafting. Methods: We identified 753 consecutive patients who underwent coronary artery bypass grafting at our centre between October 2014 and September 2016. These patients were divided into two groups: a minimally invasive extracorporeal circulation group (M, n = 229) and a conventional extracorporeal circulation group (C, n = 524). Baseline parameters, details of cardiac surgery as well as postoperative complications and outcomes were compared by means of a propensity-matched analysis of 180 matched pairs. Results: The median EuroSCORE II was 1.3%. Transfusion requirement of packed red blood cells (p = 0.002) was lower in Group M compared to conventional extracorporeal circulation systems. There were no differences in hospital mortality or in rates of adverse events between the matched groups. Total in-hospital mortality of the cohort was 1.7%. Conclusion: The use of minimally invasive extracorporeal circulation is associated with a significantly lower use of blood products after isolated coronary revascularisation. There were no differences concerning duration of surgery, complication rates and mortality between the groups. Therefore, the application of minimally invasive extracorporeal circulation systems should be considered as preferred technique in isolated coronary artery bypass grafting procedures.

scholarly journals Conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery: protocol for a randomised controlled trial (COMICS)

Perfusion ◽  
2020 ◽  
pp. 026765912094673
Author(s):  
Gianni D Angelini ◽  
Barnaby C Reeves ◽  
Jonathan Evans ◽  
Lucy A Culliford ◽  
Laura Collett ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Controlled Trial ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Randomised Controlled

Introduction: Despite low mortality, cardiac surgery patients may experience serious life-threatening post-operative complications, often due to extracorporeal circulation and reperfusion. Miniaturised cardiopulmonary bypass (minimally invasive extracorporeal circulation) has been developed aiming to reduce the risk of post-operative complications arising with conventional extracorporeal circulation. Methods: The COMICS trial is a multi-centre, international, two-group parallel randomised controlled trial testing whether type II, III or IV minimally invasive extracorporeal circulation is effective and cost-effective compared to conventional extracorporeal circulation in patients undergoing elective or urgent coronary artery bypass grafting, aortic valve replacement or coronary artery bypass grafting + aortic valve replacement. Randomisation (1:1 ratio) is concealed and stratified by centre and surgical procedure. The primary outcome is a composite of 12 serious complications, objectively defined or adjudicated, 30 days after surgery. Secondary outcomes (at 30 days) include other serious adverse events (primary safety outcome), use of blood products, length of intensive care and hospital stay and generic health status (also at 90 days). Status of the trial: Two centres started recruiting on 08 May 2018; 10 are currently recruiting and 603 patients have been randomised (11 May 2020). The recruitment rate from 01 April 2019 to 31 March 2020 was 40-50 patients/month. About 80% have had coronary artery bypass grafting only. Adherence to allocation is good. Conclusions: The trial is feasible but criteria for progressing to a full trial were not met on time. The Trial Steering and Data Monitoring Committees have recommended that the trial should currently continue.

scholarly journals Minimally invasive extracorporeal circulation improves quality of life after coronary artery bypass grafting

2016 ◽  
Vol 50 (6) ◽  
pp. 1196-1203 ◽  
Author(s):  
Kyriakos Anastasiadis ◽  
Polychronis Antonitsis ◽  
Georgia Kostarellou ◽  
Athanassios Kleontas ◽  
Apostolos Deliopoulos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Minimally invasive extracorporeal circulation is a cost-effective alternative to conventional extracorporeal circulation for coronary artery bypass grafting: propensity matched analysis

Perfusion ◽  
2020 ◽  
pp. 026765912092918
Author(s):  
Jason M Ali ◽  
Maksym Kovzel ◽  
Eve McPhilimey ◽  
Simon Colah ◽  
Ravi De Silva ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
The Mean

Introduction: Minimally invasive extracorporeal circulation has developed with the aim of reducing the impact of the adverse effects associated with conventional extracorporeal circulation. The aim of this study was to compare outcomes for patients undergoing coronary artery bypass grafting using minimally invasive extracorporeal circulation with those performed using conventional extracorporeal circulation. Methods: A retrospective analysis was performed of patients undergoing minimally invasive extracorporeal circulation coronary artery bypass grafting at a single centre. 2:1 propensity matching was performed to identify control patients undergoing conventional extracorporeal circulation coronary artery bypass grafting. Outcomes were compared using univariate analysis. Results: A total of 354 patients were included in the study, with 118 patients undergoing minimally invasive extracorporeal circulation coronary artery bypass grafting. Patients were well matched on baseline characteristics. The mean logistic EuroSCORE was 3.95 ± 4.20. Operative times (3.31 ± 1.52 vs. 3.56 ± 0.73, p = 0.03) were significantly shorter in minimally invasive extracorporeal circulation cases. Patients who underwent surgery with minimally invasive extracorporeal circulation had significantly less 12-hour blood loss (322.3 ± 13.2 mL vs. 380.8 ± 15.2 mL, p < 0.01). Correspondingly, a significantly lower proportion of patients were transfused (25.8% vs. 36%, p = 0.04), and the mean number of red blood cells transfused was lower (0.45 ± 0.95 vs. 0.97 ± 2.13, p = 0.01). Similarly, the number of coagulation products administered was lower (0.161 ± 0.05 vs. 0.40 ± 0.09, p = 0.05). There was a significantly lower incidence of acute kidney injury (11.0% vs. 19.9%, p = 0.03). Minimally invasive extracorporeal circulation was associated with a £679.50 cost saving per patient. Discussion: Minimally invasive extracorporeal circulation for coronary artery bypass grafting is associated with a reduced requirement for blood transfusion, reduced incidence of acute kidney injury and a significant cost saving. Minimally invasive extracorporeal circulation should be considered as an adjunct for all patients undergoing coronary artery bypass grafting.

Robot-Assisted Off-Pump Minimally Invasive Reoperative Coronary Artery Bypass Grafting: Case Report

2004 ◽  
Vol 7 (6) ◽  
pp. E533-E534 ◽  
Author(s):  
Timothy P. Martens ◽  
Marco M. Hefti ◽  
Robert Kalimi ◽  
Craig R. Smith ◽  
Michael Argenziano
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Robot Assisted ◽  
Artery Bypass Grafting ◽  
Off Pump

Coronary Artery Bypass Grafting using Bilateral Internal Thoracic Arteries through a Left-Sided Minithoracotomy: A Single-Center Starting Experience

2018 ◽  
Vol 67 (06) ◽  
pp. 437-443 ◽  
Author(s):  
Mahmoud Diab ◽  
Gloria Färber ◽  
Christoph Sponholz ◽  
Raphael Tasar ◽  
Thomas Lehmann ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Term Survival ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Sf 36

Abstract Background Coronary artery bypass grafting (CABG) using bilateral internal thoracic artery (BITA) is associated with the best long-term survival. However, using BITA increases the risk of sternal wound infections with conventional sternotomy. We describe here our initial results of minimally invasive CABG (MICS-CABG) using BITA. Methods Patients were operated through an incision similar to that of standard minimally invasive direct CABG. All operations were performed off-pump. We evaluated patient's quality of life (QoL) using the Medical Outcomes trust, 36-Item Short Form Health Survey (SF-36). Results Between February 2016 and August 2017, we performed 21 cases of MICS-CABG using BITA. There was no intraoperative complication and no conversion to sternotomy or to on-pump. Two patients required reexploration through the same minithoracotomy for postoperative bleeding. Two cases of early postoperative graft failure were identified. There was no stroke or in-hospital mortality. The median duration of follow-up was 13 months, with a maximum of 19 months. Relief of angina was achieved in all patients. There was one readmission for superficial wound infection, which was conservatively treated. An 84-year-old man died 4 months after the operation. The remaining 20 patients attested good QoL with the SF-36 questionnaire. Conclusions Myocardial revascularization using BITA can be safely achieved off-pump through a left-sided minithoracotomy with good postoperative and short-term outcomes.

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