Comparisons of perioperative period features and forward outcome between extracorporeal membrane oxygenation-conventional cardiopulmonary switch and off-pump high-risk coronary artery bypass grafting
10.3760/cma.j.issn.0254-9026.2017.04.017
- VernacularTitle:体外膜肺氧合-常规体外循环转换与非停跳下高危冠状动脉旁路移植术的比较
- Author:
Lei HUANG
;
Tong LI
;
Xiaomin HU
;
Dawei DUAN
;
Yingwu LIU
;
Peng WU
;
Qiang ZHANG
;
Yuheng LANG
;
Xin LU
;
Song WANG
;
Yue ZHAO
- Keywords:
Coronary artery bypass;
Extracorporeal circulation;
Extracorporeal membrane oxygenation
- From:
Chinese Journal of Geriatrics
2017;36(4):422-427
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the perioperative characteristics and long term outcomes between extracorporeal membrane oxygenation (ECMO)-conventional cardiopulmonary switch (experimental group,26 cases) and off-pump high-risk coronary artery bypass grafting (OPCABG group,24cases).Methods Perioperative characteristics and survival rate were retrospectively analyzed between experimental group and OPCABG group.Long term survival rates without major cardiovascular adverse events (MACE) were comparatively analyzed via Kaplan-Meier curves.Results The average Euroscore value were 11.7 ± 2.4 and 10.9 ± 2.0,respectively(P =0.208).The experimental group had a higher complete revascularization rate (96.2％ vs.66.7％,P =0.009),a shorter length of postoperative ECMO support [(33.1±23.6)h vs.(80.8±18.5)h],an intensive care unit stay[(4.8±1.1)d vs.(10.2±9.0)d]and a hospital stay [(17.7±6.3)d vs.(28.2±17.5)d] (all P＜0.05) as compared with OPCABG group.Preoperative New York Heart Association (NYHA) grading of cardiac function (r =0.511,P =0.008) and intraoperative ultrafiltration volume (r =-0.442,P =0.024) were significantly correlated with postoperative ECMO continuation in the experimental group.The follow-up period was (45.4 ± 15.2) months.The experimental group had a higher survival rate without MACE than had the OPCABG group (Log-rank test:x2=4.828,P=0.028).Conclusions The ECMO-conventional cardiopulmonary switch mode might facilitate a higher complete revascularization,a lower incidence of postoperative morbidities and improve the longterm survival rate without MACE for patients with high risks.
