On Pump versus Off Pump Coronary Artery Bypass Surgery in Patients Over Seventy Years Old with Triple Vessels Disease and Severe Left Ventricle Dysfunction: Focus on Early Clinical Outcomes

  • Seyed Jalil Mirhosseini Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Seyed Khalil Forouzannia Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Sadegh Ali-Hassan-Sayegh Medical Student and Researcher of Cardiac Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mehdi Hadad-Zadeh Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mohammad Hassan Abdollahi Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Hossein Moshtaghiom Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Habiballah Hosseini Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Keywords:
Off pump CABG, On pump CABG, Outcome, Patients over seventy years old

Abstract

Cardiovascular disease is the leading reason of morbidity in older people. Coronary artery bypass graft (CABG) surgery is the most common type of operations in world. This study was designed to characterize comparison of early clinical outcome following on pump vs. off pump in patients over 70 years old with triple vessels disease and severe left ventricle dysfunction. 80 patients were divided into two groups: In group A (n=40) on pump CABG was performed with hypothermic cardiopulmonary bypass and cold blood cardioplegic arrest and in group B (n=40) the patients had off pump coronary artery bypass (OPCAB) surgery. Exclusion criteria included emergency or urgent operation, combined valve surgery, history of renal insufficiency (Cr >2 mg/dl), stroke. Early postoperative complications such as occurrence, duration and frequency of recurrence of atrial fibrillation were recorded. All patients underwent Holter monitoring after ICU discharge during their hospital stay. The average age of patients was 79.5±7.5 years. Post operative atrial fibrillation (POAF) occurred in 24 cases (30%); 17 cases (42.5%) related to on pump CABG group and 7 cases (17.5%) related to OPCAB group (P=0.03). The frequency of the recurrence of AF in the on pump group was 3.8±1.3 days and in the off pump group was 2.4±1.1 days (P=0.02). ICU stay in on pump group was 3.6±1.80 days, while for the off pump was 2.5±0.6 days (P=0.001). Also hospital stay duration was 8.5±2.1 days for the on pump group compared to the other group that was 6.34±1.06 days. Off pump in patients over 70 years old with triple vessels disease and severe LV dysfunction is safer than on pump and can reduce POAF, ICU and hospital stay and some early surgical complications.

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How to Cite
1.
Mirhosseini SJ, Forouzannia SK, Ali-Hassan-Sayegh S, Hadad-Zadeh M, Abdollahi MH, Moshtaghiom H, Hosseini H. On Pump versus Off Pump Coronary Artery Bypass Surgery in Patients Over Seventy Years Old with Triple Vessels Disease and Severe Left Ventricle Dysfunction: Focus on Early Clinical Outcomes. Acta Med Iran. 51(5):320-323.
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