Minimal Extracorporeal Circulation and Microplegia in the Setting of Urgent Coronary Artery Bypass Grafting.

coronary artery bypass grafting microplegia minimal extracorporeal circulation system myocardial infarction myocardial protection perfusion

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
17 Dec 2022
Historique:
received: 17 10 2022
revised: 01 12 2022
accepted: 12 12 2022
entrez: 23 12 2022
pubmed: 24 12 2022
medline: 24 12 2022
Statut: epublish

Résumé

Background: We aimed to analyse the performance of minimal invasive extracorporeal circulation (MiECC) concomitantly with Microplegia, in patients with recent myocardial infarction (MI) undergoing urgent coronary artery bypass grafting (CABG) surgery. Methods: We included patients with a recent MI (≤7 days) undergoing isolated CABG surgery using MiECC. The primary endpoint was a major cardiovascular or cerebrovascular event (MACCE). In a secondary analysis, we compared our institutional Microplegia concept with the use of a crystalloid single-shot cardioplegic solution. Results: In total, 139 patients (mean ± standard deviation (SD) age 66 ± 10 years) underwent urgent CABG surgery using Microplegia; 55% (n = 77) of the patients had an acute MI within 1−7 days preoperatively; 20% (n = 28) had an acute MI within 6−24 h; and 24% (n = 34) had an acute MI within <6 h preoperatively. The number of distal anastomoses was a geometric mean of 4 (95% confidence interval 3−4). The MACCE and in-hospital mortality were 7% (n = 10) and 1% (n = 2), respectively. The results were confirmed in a secondary analysis comparing Microplegia with crystalloid cardioplegic solution (n = 271). Conclusion: The use of MiECC with Microplegia in urgent CABG surgery is feasible and safe and provides a straight-forward intraoperative setting. Therefore, it can also be considered to retain the benefits of MiECC in urgent CABG surgery.

Identifiants

pubmed: 36556103
pii: jcm11247488
doi: 10.3390/jcm11247488
pmc: PMC9781499
pii:
doi:

Types de publication

Journal Article

Langues

eng

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

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Auteurs

Luca Koechlin (L)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Brigitta Gahl (B)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Surgical Outcome Research Center Basel, University Hospital Basel, University Basel, 4031 Basel, Switzerland.

Jules Miazza (J)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Urs Zenklusen (U)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Bejtush Rrahmani (B)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Ion Vasiloi (I)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

David Santer (D)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Denis Berdajs (D)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Friedrich S Eckstein (FS)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Oliver Reuthebuch (O)

Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.

Classifications MeSH