Prognosis and Risk Factor Analysis for Conversion From Off-Pump Coronary Artery Bypass Grafting to Cardiopulmonary Bypass Grafting During Surgery
10.3969/j.issn.1000-3614.2014.11.006
- VernacularTitle:非体外循环冠状动脉旁路移植术中转体外循环的预后、原因及危险因素分析
- Author:
Xi LIU
;
Yu CHEN
;
Zhou ZHAO
;
Suixin DONG
;
Gang LIU
;
Shenglong CHEN
;
Yunpeng LING
;
Hui LI
;
Bo LIAN
;
Liming BAO
;
Wei YANG
- Publication Type:Journal Article
- Keywords:
Off-pump coronary artery bypass;
Conversion;
Outcome;
Prognosis
- From:
Chinese Circulation Journal
2014;(11):879-883
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognosis and risk factors for conversion from off-pump coronary artery bypass grafting (OPCABG) to coronary bypass grafting (CABG) during surgery.
Methods: We retrospectively analyzed 2613 patients with elective OPCAB in our hospital from 2001 to 2012, there were 62 (2.37%) patients converted to CABG during the operation as Conversion group, the rest 2551 patients were set as Non-conversion group. The peril-operative baseline clinical data and prognosis condition were compared between 2 groups. The risk factors causing the in-operative conversion were studied with binary logistic regression analysis.
Results: The total conversion rate was 2.37%, including 42 patients of hemodynamic instability, 6 with dififculty of target vessel exposure, 9 with malignant arrhythmia, 3 with graft occlusion and 2 patients with other reasons. Compared with Non-conversion group, the Conversion group had increased post-operative drainage and ventilation time, higher rates of second thoracotomy for stop bleeding and higher peril-operative mortality. Binary logistic regression analysis indicated that chronic obstructive pulmonary disease, previous history of CABG, NYHA class≥3, LVEF≤40%and left main disease were the independent risk factors for in-operative conversion.
Conclusion: Conversion from OPCAB to CABG during the operation would be result in signiifcantly higher morbidity and mortality in relevant patients.