Background: Off -pump coronary bypass grafting (OPCAB) is a routine method of heart revascularization. Thisstudy was designed to compare the results of OPCAB and ONCAB performed by a single surgeon at our institutionover a 3-year period.Methods: The study enrolled 345 patients undergoing elective myocardial revascularization procedures, of which173 (50.1%) were OPCAB and 172 (49.9 %) were ONCAB. The postoperative outcomes of both groups were analyzed,retrospectively.Results: The mean number of grafts was signifi cantly lower in the OPCAB group (2.9) than in the ONCAB group(3.7). There were no postoperative myocardial infarctions or hospital deaths in any of the patients. The postoperativetotal blood loss was signifi cantly higher in the ONCAB group. The frequencies of postoperative confused states,strokes, postoperative transfusions, reoperations for bleeding, and atrial fi brillation, and the durations of intubation,ICU stay, and hospital stay did not diff er signifi cantly between the two groups.Conclusions: The OPCAB procedures are safe and provide good clinical outcomes, similar to those of ONCABoperations. The outcomes of this study favor neither of the compared techniques.
- MeSH
- dospělí MeSH
- kardiovaskulární chirurgické výkony metody využití MeSH
- koronární bypass metody přístrojové vybavení využití MeSH
- lidé MeSH
- pooperační komplikace MeSH
- přístroj pro mimotělní oběh využití MeSH
- retrospektivní studie MeSH
- revaskularizace myokardu metody přístrojové vybavení využití MeSH
- senioři MeSH
- statistika jako téma MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- senioři MeSH
Aims: Cardiac surgery patients are prone to bleeding postoperatively owing to the extensive sternotomy wound,multiple vessel and heart sutures, and disorders of hemostasis. In this study we retrospectively analyzed the outcomesfor all patients in our department who were re-operated for bleeding, over a 5 year period. Methods: A total of 4297 patients underwent heart surgery between February 2002 and January 2007, of which 98(2.3 %) were emergency reoperations for bleeding. We analyzed the process of indication for repeat surgery, possiblesource of bleeding, and postoperative complications. Results: Most (85.7 %) of the reoperated patients had undergone their fi rst operation as an elective cardiac procedure.The mean blood loss before the reoperation was 1557 ml. The studied group was characterized by increasedmortality (11.2 %), longer ventilation period (35.1 hours) and ICU (4.5 days) and hospital (13.3 days) stays. Thepostoperative outcomes did not diff er signifi cantly between patients with TEG-detected coagulation disorder and therest of the patients, or between patients treated with antilysin and those who did not receive antifi brinolytics. Conclusions: It is vital for the indication process leading to reoperation of the bleeding patient to be as short aspossible so as to minimize the delay to repeat surgery. Echocardiography including ultrasound of both pleural spaces,and TEG could shorten that time delay, and should always be included when evaluating patients. Platelets should beadministered more often, with the use of antifi brinolytics reserved for cases with confi rmed fi brinolysis.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- echokardiografie metody využití MeSH
- kardiochirurgické výkony metody škodlivé účinky využití MeSH
- koronární jednotky metody využití MeSH
- krevní transfuze metody využití MeSH
- lidé MeSH
- pleurální dutina ultrasonografie MeSH
- pooperační krvácení chirurgie komplikace MeSH
- reoperace metody využití MeSH
- retrospektivní studie MeSH
- srdeční tamponáda diagnóza chirurgie MeSH
- statistika jako téma MeSH
- tromboelastografie metody využití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakt z konference MeSH
