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Minimal Extracorporeal Circulation: An Alternative for On-Pump and Off-Pump Coronary Revascularization
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| 09.03.2009, 15:30 |
Background. Coronary artery bypass surgery employing
minimal extracorporeal circulation (MECC) was compared
with standard extracorporeal circulation (ECC) and offpump
coronary artery bypass graft surgery (OPCABG) with
regard to the perioperative course.
Methods. From January 2004 to December 2007, 1,674
patients (n 558 MECC, n 558 ECC, n 558 OPCABG)
who underwent coronary bypass surgery were studied.
The primary end point was in-hospital mortality; secondary
end points were perioperative variables, intensive
care, and in-hospital course.
Results. Demographic data, comorbidity, and the European
System for Cardiac Operative Risk Evaluation
score (MECC 3.0%, ECC 3.5%, OPCABG 3.2%) were
similar among the groups, but in-hospital mortality for
elective and urgent/emergent patients was lower in the
MECC and OPCABG groups (MECC 3.2%, OPCABG
3.7%, ECC 6.9%; p < 0.05). The number of distal anastomoses
was lowest in the OPCABG group, but comparable
for MECC and ECC patients. Postoperative ventilation
time, release of creatinine kinase, catecholamine
therapy, drainage loss, and transfusion requirements
were lower in the MECC and OPCABG groups, whereas
stay in the intensive care unit was shorter only in the
latter (p < 0.05).
Conclusions. Minimal extracorporeal circulation is an
easy and safe procedure for coronary artery bypass graft
surgery. In selected patients, the advantages of MECC
equal those of OPCABG. MECC should be considered as
an alternative to OPCABG and standard ECC procedures.
(Ann Thorac Surg 2009;87:766 –72)
© 2009 by The Society of Thoracic Surgeons
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| Категория: Статьи | Добавил: nbylova
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