Off pump coronary artery bypass surgery for significant left ventricular dysfunction

Safety, feasibility, and trends in methodology over time - An early experience

Erez Sharoni, Howard Song, R. J. Peterson, R. A. Guyton, J. D. Puskas

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design: Retrospective study. Setting: Tertiary care university affiliated referral centre. Participants: 353 consecutive patients with preoperative left ventricular ejection fraction ≤ 35% who underwent coronary artery bypass over a three year period. Main outcome measures: Postoperative morbidity and mortality. Methods: 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre- and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results: Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13% to 67%), without any impact on morbidity or mortality. Conclusions: OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach.

Original languageEnglish (US)
Pages (from-to)499-502
Number of pages4
JournalHeart
Volume92
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

Fingerprint

Off-Pump Coronary Artery Bypass
Left Ventricular Dysfunction
Coronary Artery Bypass
Safety
Morbidity
Mortality
Angina Pectoris
Tertiary Healthcare
Hospital Mortality
Left Ventricular Function
Pulmonary Hypertension
Stroke Volume
Chronic Obstructive Pulmonary Disease
Length of Stay
Referral and Consultation
Multivariate Analysis
Heart Failure
Retrospective Studies
Myocardial Infarction
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Off pump coronary artery bypass surgery for significant left ventricular dysfunction : Safety, feasibility, and trends in methodology over time - An early experience. / Sharoni, Erez; Song, Howard; Peterson, R. J.; Guyton, R. A.; Puskas, J. D.

In: Heart, Vol. 92, No. 4, 04.2006, p. 499-502.

Research output: Contribution to journalArticle

@article{551cdae517314b50a2e38462bcb6aea6,
title = "Off pump coronary artery bypass surgery for significant left ventricular dysfunction: Safety, feasibility, and trends in methodology over time - An early experience",
abstract = "Objective: To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design: Retrospective study. Setting: Tertiary care university affiliated referral centre. Participants: 353 consecutive patients with preoperative left ventricular ejection fraction ≤ 35{\%} who underwent coronary artery bypass over a three year period. Main outcome measures: Postoperative morbidity and mortality. Methods: 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre- and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results: Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13{\%} to 67{\%}), without any impact on morbidity or mortality. Conclusions: OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach.",
author = "Erez Sharoni and Howard Song and Peterson, {R. J.} and Guyton, {R. A.} and Puskas, {J. D.}",
year = "2006",
month = "4",
doi = "10.1136/hrt.2005.062778",
language = "English (US)",
volume = "92",
pages = "499--502",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Off pump coronary artery bypass surgery for significant left ventricular dysfunction

T2 - Safety, feasibility, and trends in methodology over time - An early experience

AU - Sharoni, Erez

AU - Song, Howard

AU - Peterson, R. J.

AU - Guyton, R. A.

AU - Puskas, J. D.

PY - 2006/4

Y1 - 2006/4

N2 - Objective: To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design: Retrospective study. Setting: Tertiary care university affiliated referral centre. Participants: 353 consecutive patients with preoperative left ventricular ejection fraction ≤ 35% who underwent coronary artery bypass over a three year period. Main outcome measures: Postoperative morbidity and mortality. Methods: 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre- and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results: Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13% to 67%), without any impact on morbidity or mortality. Conclusions: OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach.

AB - Objective: To examine the safety and applicability of off pump coronary artery bypass surgery (OPCAB) in patients with significant left ventricular dysfunction and to discuss the clinical implications for the surgical methods. Design: Retrospective study. Setting: Tertiary care university affiliated referral centre. Participants: 353 consecutive patients with preoperative left ventricular ejection fraction ≤ 35% who underwent coronary artery bypass over a three year period. Main outcome measures: Postoperative morbidity and mortality. Methods: 144 patients operated by OPCAB were compared with 209 patients operated by conventional coronary artery bypass. Multivariate and univariate analyses were performed on the pre- and postoperative variables to predict risk factors associated with hospital morbidity and mortality. Results: Patients in the OPCAB group were more likely to be women and to have congestive heart failure, chronic obstructive pulmonary disease, hypertension, and diabetes; patients in the on pump group were more likely to have had a recent myocardial infarction and to have more severe angina pectoris and an urgent/emergent status. The groups did not differ significantly in length of stay, major postoperative complication rates, or mortality. Comparison of the impact of the procedures on surgical methods over time showed an increase in the use of OPCAB (13% to 67%), without any impact on morbidity or mortality. Conclusions: OPCAB is feasible and applicable for patients with depressed left ventricular function. This high risk group can potentially benefit from the off pump approach.

UR - http://www.scopus.com/inward/record.url?scp=33645213548&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645213548&partnerID=8YFLogxK

U2 - 10.1136/hrt.2005.062778

DO - 10.1136/hrt.2005.062778

M3 - Article

VL - 92

SP - 499

EP - 502

JO - Heart

JF - Heart

SN - 1355-6037

IS - 4

ER -