The risk factors associated with intraoperative acute cardiac decompensation in patients undergoing off-pump coronary artery bypass grafting
10.3760/cma.j.issn.0254-1416.2010.05.004
- VernacularTitle:非体外循环冠状动脉旁路移植术患者术中急性心功能失代偿的危险因素
- Author:
Xiuhua DONG
;
Jiakai LU
;
Enming QING
;
Yijun WANG
;
Xueyong WANG
- Publication Type:Journal Article
- Keywords:
Risk factors;
Coronary artery bypass,off-pump;
Heart failure
- From:
Chinese Journal of Anesthesiology
2010;30(5):524-526
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the risk factors associated with intraoperative acute cardiac decompensation in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods From November 2007 to February 2009, 2379 OPCABGs were performed in our hospital. The possible risk factors associated with intraoperative cardiac decompensation were retrospectively analyzed. The preoperative patient demographics and intraoperative characteristics were correlated with intraoperative acute cardiac decompensation.The possible risk factors included sex, age, body weight, cardiac function (NYHA classification), the associated diseases (hypertension, diabetes mellitus, liver-kidney dysfunction), history of myocardial infarct, ventricular aneurysm, preoperative treatment with β-blocker and/or calcium channel blocking agent, ventricular extrasystole,atrial fibrillation, duration of operation, etc. Results Three hundred and sixty-eight patients developed acute cardiac decompensation during OPCABG (15.5%). No patient died during operation. Multivariate analysis indicated that the risk factors for acute cardiac decompensation during OPCABG included left ventricular aneurysm valvular dysfunction, left main disease, history of myocardial infarct, preoperative ventricular premature beat,preoperative ejection fraction (EF) ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG. Conclusion The risk factors for acute cardiac decompensation during OPCABG includ left ventricular aneurysm valvular dysfunction, left main disease,history of myocardial infarct, preoperative ventricular premature beat, preoperative EF ＜ 40%, intraoperative atrial fibrillation, intraoperative frequent ventricular premature beat, tachycardia before anesthesia and emergency OPCABG.
