Heart Assisting Options in off Pump Coronary Surgery in AlNajaf center for Cardiac surgery and Trans-catheter Therapy / Al-Najaf / Iraq
Keywords:
Off-Pump Coronary Artery Bypass (OPCAB) Surgery, Assisted option, On-Pump conversion, Intra-Aortic Balloon Pump (IABP), PacingAbstract
BackgroundCoronary artery disease has increasing frequency worldwide and considered as important cause
of mortality, Off-pump coronary artery bypass grafting (OPCAB) has been shown to be a good way
for surgical revascularization.
Aim of study
The aim is to find any correlation between the demographic and clinical characteristic
of the patients from a side and the need for an assisted option while the patient having an
OPCAB and interpretation of any possible cause factor.
Patients and Methods
A retrospective study enrolled a 168 patients who underwent an OPCAB in Al-Najaf Cardiac
center in the period from the 1
st of January 2015 till the 1
st of December 2018. The Preoperative demographic and clinical characteristics of the studied group were gathered to detect
possible cause factors for using any OPCAB assisted option like the conversion to
cardiopulmonary bypass machine, Intra-Aortic balloon pump (IABP) use or the epi-cardial
pacing. Descriptive statistics used to interpret the data, Chi-squared and Fisher’s exact tests used
to detect the significant correlation between the dependent and the independent variables beside
the bivariate correlation analysis.
Results
Smoking, arrhythmia, low left ventricular ejection fraction (EF) and left circulation dominancy
were significantly associated with higher conversion rate (Pvalue<0.005), in other hand the use of
IABP show significant association with lager body mass indices, renal impairment, arrhythmia, left
main stem involvement (LMS), low EF, multi-vessel disease and left coronary circulation dominancy,
while temporary pacing implantation show only correlation with age off more than 55 year. Rate of
conversion and the use of an assisted option correlated with more mortality and ICU stay time.
Conclusions
Higher conversion rate, use of IABP and pacing associated with older age, smokers, those with
low EF, multi-vessel disease and LMS involvement who required planned application of preoperative IABP. Assisted options are predictors of mortality and associated with longer ICU stay
time.
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