Comparative Study on Early and Long-term Outcomes Between On-pump and Off-pump Coronary Artery Bypass Grafting in Elder Female Patients
10.3969/j.issn.1000-3614.2015.12.003
- VernacularTitle:老年女性患者体外循环和非体外循环下冠状动脉旁路移植术近远期预后对比
- Author:
Jiqiang ZHANG
;
Heng ZHANG
;
Junzhe DU
;
Wei FENG
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass,off-pump;
On-pump;
Elder;
Female
- From:
Chinese Circulation Journal
2015;(12):1143-1146
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the early and long-term outcomes between on-pump and off-pump coronary artery bypass grafting (CABG) in elder female patients.
Methods: A total of 763 female patients elder than 65 years of age received isolated CABG in our hospital from 1999-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups according to operational method: On-pump group,n=331 and Off-pump group,n=432. The mortality at 30 days post-operation, in-hospital clinical indexes and long term mortality with MACCE as all cause death, myocardial infarction (MI), stroke and repeated revascularization were compared between 2 groups.
Results: Compared with On-pump group, the patients in Off-pump group had the elder age (P<0.01), with the higher rate of cerebral vascular accident (P=0.023); less family history of coronary artery disease (P=0.012), angina (P<0.001) and emergent operation (P=0.015), less venous distal anastomoses (P<0.001) ; while higher incomplete revascularization (P<0.001). Logistic regression model comparison indicated that Off-pump group had the lower mortality at 30 days post-operation (P=0.038), less application of blood products (P<0.001), lower rate of >24h mechanical ventilation (P<0.001), less renal failure (P=0.022), pulmonary complications (P<0.001) and re-exploration for bleeding (P=0.021). The morbidity of all post-operative complications were similar between 2 groups (P=0.110). Cox regression model comparison showed that long-term all cause mortality (P=0.477) and occurrence of MACCE (P=0.265) were similar between the two groups.
Conclusion: Off-pump CABG would reduce the mortality at 30 days post-operation, have less application of blood products, shorter post-operative mechanical ventilation, less early post-operative renal failure, pulmonary complications and re-exploration for bleeding. While it could not reduce the long-term mortality and MACCE occurrence.
