Emergency surgery for left main disease: with and without cardioplegic arrest.


Journal

Asian cardiovascular & thoracic annals
ISSN: 1816-5370
Titre abrégé: Asian Cardiovasc Thorac Ann
Pays: England
ID NLM: 9503417

Informations de publication

Date de publication:
Mar 2019
Historique:
pubmed: 22 1 2019
medline: 23 4 2019
entrez: 22 1 2019
Statut: ppublish

Résumé

The aims of this study were to evaluate the on-pump beating-heart technique of coronary artery bypass in patients with acute myocardial infarction and left main disease, and to retrospectively compare the early postoperative results with those of conventional on-pump arrested-heart coronary surgery. Eighty-five patients with acute myocardial infarction caused by left main disease, who underwent emergency surgery between January 1998 and April 2017 at Saiseikai Utsunomiya Hospital, were enrolled in this study. Of these patients, 56 were evaluated using propensity-matched analysis. The patients were divided into two groups according to the surgical procedure: group A ( n = 28) had on-pump surgery on the arrested heart, and group B ( n = 28) had on-pump surgery on the beating heart. Early postoperative results were compared between the two groups. Preoperative and intraoperative characteristics showed no significant differences between the two groups. The peak creatine kinase myocardial band level was significantly lower in group B (group A 151 vs. group B 91 IU·L There was no significant advantage based on surgical procedure between on-pump beating-heart surgery and on-pump surgery on the arrested heart. On-pump beating-heart coronary artery bypass grafting significantly reduced the peak creatine kinase myocardial band level, but there were no significant differences in the early postoperative data, including the mortality rate and left ventricular function.

Sections du résumé

BACKGROUND BACKGROUND
The aims of this study were to evaluate the on-pump beating-heart technique of coronary artery bypass in patients with acute myocardial infarction and left main disease, and to retrospectively compare the early postoperative results with those of conventional on-pump arrested-heart coronary surgery.
METHODS METHODS
Eighty-five patients with acute myocardial infarction caused by left main disease, who underwent emergency surgery between January 1998 and April 2017 at Saiseikai Utsunomiya Hospital, were enrolled in this study. Of these patients, 56 were evaluated using propensity-matched analysis. The patients were divided into two groups according to the surgical procedure: group A ( n = 28) had on-pump surgery on the arrested heart, and group B ( n = 28) had on-pump surgery on the beating heart. Early postoperative results were compared between the two groups.
RESULTS RESULTS
Preoperative and intraoperative characteristics showed no significant differences between the two groups. The peak creatine kinase myocardial band level was significantly lower in group B (group A 151 vs. group B 91 IU·L
CONCLUSIONS CONCLUSIONS
There was no significant advantage based on surgical procedure between on-pump beating-heart surgery and on-pump surgery on the arrested heart. On-pump beating-heart coronary artery bypass grafting significantly reduced the peak creatine kinase myocardial band level, but there were no significant differences in the early postoperative data, including the mortality rate and left ventricular function.

Identifiants

pubmed: 30661379
doi: 10.1177/0218492319826434
doi:

Substances chimiques

Biomarkers 0
Creatine Kinase, MB Form EC 2.7.3.2

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

157-162

Auteurs

Koji Tsutsumi (K)

1 Division of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
2 Department of Cardiovascular Surgery, National Defense Medical College, Saitama, Japan.

Osamu Ishida (O)

2 Department of Cardiovascular Surgery, National Defense Medical College, Saitama, Japan.

Kenichi Hashizume (K)

1 Division of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.

Yoshito Inoue (Y)

1 Division of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
3 Division of Cardiovascular Surgery, Hiratsuka Municipal Hospital, Kanagawa, Japan.

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Classifications MeSH