Perioperative safety and feasibility of simultaneous off-pump coronary artery bypass grafting with non-cardiac surgical procedures of moderate-to-severe severity
10.3760/cma.j.cn112139-20200408-00286
- VernacularTitle:非体外循环冠状动脉旁路移植术联合中度以上创伤非心脏手术的围手术期安全性研究及可行性评价
- Author:
Shiyong DONG
1
;
Jin WANG
;
Siyu ZHANG
;
Yiding ZHANG
;
Yang YANG
;
Feng XIAO
Author Information
1. 北京大学第一医院心脏外科 100034
- Keywords:
Coronary artery bypass, off-pump;
Surgical procedures, operative;
Non-cardiac surgical procedures
- From:
Chinese Journal of Surgery
2021;59(1):46-51
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the perioperative safety and feasibility of simultaneous off-pump coronary artery bypass grafting (OPCAB) with non-cardiac surgical procedures of moderate-to-severe severity.Methods:The perioperative results of 54 patients underwent simultaneous OPCAB with non-cardiac surgical procedures from September 2013 to January 2019 at Department of Cardiac Surgery, Peking University First Hospital were assessed retrospectively. There were 46 males and 8 females, aging (65.8±8.8) years (range: 41 to 85 years). All simultaneous non-cardiac surgical procedures, including vascular ( n=1), thoracic ( n=26), general ( n=12) and urologic surgical procedures ( n=15), were assessed to be of moderate-to-severe grade by operative severity scoring system. Perioperative results were compared between the OPCAB patients who underwent simultaneous non-cardiac surgical procedures ( n=54) and 1∶2 matched patients who underwent isolated OPCAB performed most recently by the same cardiac team with similar procedures accordingly ( n=108), using t test, Mann-Whitney U test, χ2 test or Fisher exact test. Results:All baseline factors were matched between the two groups, with no significant difference on European system for cardiac operative risk evaluation (EuroSCORE) Ⅱ (1.185(0.758)% vs. 1.215(0.905)%, Z=?0.036, P=0.972). No perioperative death was observed in the two groups. Although patients underwent simultaneous non-cardiac surgical procedures showed prolonged operation duration time ((324.9±97.1) minutes vs. (166.7±36.7) minites, t=11.564, P<0.01) and increased intraoperaive blood loss ((462.2±269.6) ml vs. (304.5±177.8) ml, t=3.866, P<0.01), primary postoperative complications, including perioperative myocardial infarction, atrial fibrillation, perioperative stroke, acute renal failure, wound infection, and bleeding reoperation did not show significant differences between the two groups (all P>0.05), while total blood transfusion volume, mechanical ventilation time and intensive care unit residence time also showed no significant differences between the two groups (all P>0.05). Conclusion:Simultaneous OPCAB with non-cardiac surgical procedures of moderate-to-severe severity in patients with operative indications are safe and feasible, and are not associated with increased postoperative risks when compared with isolated OPCAB.
