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Báo cáo y học: "Off-pump versus on-pump coronary artery bypass grafting in acute coronary syndrome: a clinical analysis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Off-pump versus on-pump coronary artery bypass grafting in acute coronary syndrome: a clinical analysis. | Kaya et al. Journal of Cardiothoracic Surgery 2010 5 31 http www.cardiothoracicsurgery.Org content 5 1 31 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Off-pump versus on-pump coronary artery bypass grafting in acute coronary syndrome a clinical analysis Kaan Kaya 1 Raif Cavolli1 Alpaslan Telli1 Mehmet Fazil Tolga Soyal1 Alp Aslan2 Gokhan Gokaslan1 ahin Mursel3 and RefikTasoz1 Abstract Background Although off-pump coronary artery bypass OPCAB surgery has many beneficial effects compared with on-pump surgery switch to on-pump surgery has significantly higher risks of operative mortality. Benefits of OPCAB over on-pump surgery strategies concerning myocardial revascularization are still debatable. We have aimed to develop an algorithm of off-pump surgical strategy on preventing conversion to on-pump. This clinical study reports our clinical outcome of OPCAB in patients with acute coronary syndrome. Methods Between January 2006 and December 2008 198 patients with acute coronary syndrome were enrolled in the study. Decision of OPCAB 142 patients or on-pump surgery 56 patients was made according to patients present clinical status and our surgical background. Cardiac enzymes duration of the surgery graft numbers stay in intensive care unit were recorded. Results OPCAP group has shorter operation time 82.78 min versus 164.22 min p 0.001 lesser necessity for intraaortic balloon pumping 3.5 versus 12.5 p 0.053 shorter duration of intensive care unit stay p 0.05 and hospital stay p 0.001 compared to on-pump patients. EuroSCORE level was lower in OPCAP group p 0.001 . None of the patients of OPCAB group required conversion to on-pump technique. Conclusions The patients who admitted to the hospital with acute coronary syndrome within golden hours within 6 hours after onset had a greater chance for OPCAB surgery. This study proves that EuroSCORE is likely to be an important factor in deciding which surgical technique to use but a further investigation is