Impact of On-Pump Coronary Artery Bypass Graft Surgery vs. Off-Pump on Renal Function in Patients with Impaired Renal Function
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Background: The impact of the surgical technique of coronary artery bypass graft (CABG) surgery on renal function in patients with pre-existing kidney impairment remains a subject of debate. This study aimed to investigate the influence of on-pump (ONCAB) and off-pump (OPCAB) on renal function in patients with pre-existing impaired kidney function (GFR < 60 mL/min).Keywords:
Impaired renal function
Objective:To investigate the clinical value of Emergency Off-pump coronary artery bypass grafting(OPCAB). Methods:The data of 23 cases of emergency off-pump coronary artery bypass grafting were retrospectively analysed.Results:Two patients with hemodynamic instability were switched to On-pump coronary artery bypass grafting surgery during the operation,The other 21 cases of OPCAB surgery was successfully completed.The number of bypass grafting ranges from 2-6,3.32±0.596 on average.There were 2 deaths during Perioperative Period.Temporary atrial fibrillation occurred in 3 cases,low cardiac output syndrome in 1,lung infection in 1 patient.There was no postoperative neurological complication,no reoperation for massive haemorrhage and no acute renal failure.Conclusions:Off-pump coronary artery bypass grafting(OPCAB)appears to be minimally invasive and effective with less complications.OPCAB can be safely and effectively used in emergency coronary artery bypass surgery.
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Objective Analyze clinical effect between on-pump cor-onary artery bypass grafting and off-pump coronary artery bypass grafting.Methods We collected clinical data of 70 cases coronary artery bypass grafting in our hospital from Jan.2002 to Feb.2009,they were divided into on-pump group and off-pump group,and we analyzed their postoperative data and postoperative complication.Results there were 1 case postoperative complication in off-pump group,and 6 case postoperative complication in on-pump group;1 patient died in off-pump group,3 patients died in on-pump group.Conclusion In multi-vessel cases,there weren't difference bet-ween on-pump coronary artery bypass grafting and off-pump coronary artery bypass grafting in appliance of revesselization,postoperative morda-lity and complication were lower in off-pump coronary artery bypass grafting than in on-pump coronary artery bypass grafting,however,pa-tients with valve disease or severe 3-branch vessel disease or left major disease or ventricular wall anurhysm were more suitable to on-pump co-ronary artery bypass grafting,off-pump coronary artery bypass grafting can't replace on-pump coronary artery bypass grafting.
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Abstract: Objective;To analysis the treatment by peri-anesthesia period in off-pump coronary artery bypasses grafting (OPCABG). Methods: Retrospectively analysis the clinic data of 41 OPCABG patients. Results: In total of 41 patients performed OPCABG, the operatiens of 39 patients were successfully performed; OPCABG of 2 patients was changed to coronary artery bypass grafting with pump (CABGP), in which one patient died. One patient died after operary 3 weeks. A total of 39 patients discharged because fully recover. Conclusion: Maintaining hemodynamics to stable, protect blood, reasonable application drug for cardionascular system and preparing extra-corporeal c-irculation pump are the key of successful surgery.
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Objective To explore the protective effect of coronary artery bypass grafting(CABG) with or without cardiopulmonary bypass(CPB) in myocardial injury in the aged patients.Methods Thirty patients subject to simple CABG were randomly divided into 2 groups:CABG group(n=15),on pump with conventional CPB,and OPCAB group(n=15),off pump with beating heart.Serum levels of cardiac troponin I(cTnI) and CK-MB activity were detected right before operation,30 min,1 h,6 h,12 h,24 h,72 h and 120 h after operation.Results In the CABG group with pump in 12 h,24 h,72 h postoperation,the cTnI and CK-MB levels and the number of the patients receiving IABP and transfusion were significantly increased as compared with OPCAB group(P0.05).Conclusion Off-pump coronary artery bypass grafting in beating heart can reduce myocardial injury.
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Background: Multiple studies have compared on-pump coronary artery bypass (ONCAB) grafting with off-pump coronary artery bypass (OPCAB) grafting, but the optimal surgical strategy has yet to be established. Furthermore, there is limited evidence regarding mid-term graft patency rates.
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Objective To evaluate the advantages of off pump coronary artery bypass (OPCAB) through detection of cardial troponin I.Methods Thirty six cases of OPCAB (OPCAB group) were compared to 36 cases of coronary artery bypass grafting (CABG;control group).The plasma level of cardial troponin was observed in both groups.And the early postoperative clinical results were assessed.Results No significant difference was observed in basic clinical data in both groups.The mean level of plasma cardial troponin I was normal in OPCAB group in the 4?8?16?24 h,2?4?8 d after operation.The frequency of positive changes of ECG is less in OPCAB group than that in control group.Conclusion It seems that OPCAB provide better myocardial protection and better early results than CABG.
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Background. Repeated administration of low-molecular-weight heparin (LMWH) to elderly patients with an impaired renal function may lead to an accumulation effect with an increased risk of bleeding. In this setting, Cockcroft–Gault (CG) is the most widely used formula for glomerular filtration rate (GFR) estimation. In hospitalized patients over the age of 70, the six-variable Modification of Diet in Renal Disease (MDRD) formula was compared with the CG formula to detect patients with renal impairment who are at higher risk of bleeding when treated with LMWH.
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Background: Patent bypass grafts are fundamental to successful coronary artery bypass grafting.We studied the use of transit-time flow measurement to determine its ability to detect technical errors in grafts, to measure the mean flow norms, and to compare flow in both on-pump and off-pump CABG procedures. Aim of Study:To compare conduit flow in a standardized type of CABG and OPCAB using the Left Internal Mammary Artery (LIMA) and vein grafts.Patients and Methods: This study was conducted on 60 patients requiring coronary artery bypass surgery classified into 2 equal groups:• Group A: (Conventional CABG), who were approached through on pump CABG.• Group B: (OPCAB), whom approached without cardiopulmonary bypass machine.Results: There was no statistical difference between the two groups in baseline pre-operative characteristics regarding their age, sex, NYHA class and EF%.In Group (A), the MGF was (39.51 ± 5.26) and PI values were (2.33 ±0.64).While in Group (B), the MGF was (32.71 ± 6.47) and PI measurements were (2.71 ± 1.22).The MGF for the occluded grafts in Group A was (14.33 ±3.21) ml min and (12.75±2.87) in Group B (p=.522).The corresponding PI values were (8.03 ± 1.0) for Group A and (8.85 ± 1.67) for Group B (p=0.489).Conclusions: TTFM technique is a highly valuable equipment.Mean flow is lower in the OPCAB group with higher pulsatility index than the conventional CABG group, which raises suspicion about the long term patency of OPCAB grafts.
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Objective To analyze the changes of cardiactroponin-I between conventional on-pump coronary artery bypass grafting and off-pump coronary artery bypass grafting. Methods Forty-eight patients received coronary artery bypass grafting, in which 24 received conventional on-pump coronary artery bypass grafting(group CCABG), and the other 24 received off-pump coronary artery bypass grafting(group OPCAB).The changes of plasma cardiactroponin-I were compared between two groups. Results There was no difference in the patient's data between two groups before surgery. In the observation period, the level of plasma cardiactroponin-I was much higher in group CCABG than that in group OPCAB (P0.01). Conclusion The myocardial injury of off-pump coronary artery bypass grafting is lower than in conventional on-pump coronary artery bypass grafting.
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