| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | European Journal of Cardio-Thoracic Surgery | ||||
| Publisher: | OXFORD UNIV PRESS INC | ||||
| Place of Publication: | CARY | ||||
| Volume: | 36 | ||||
| Number of Issue or Book Chapter: | 5 | ||||
| Page Range: | pp. 844-848 | ||||
| Date: | 2009 | ||||
| Institutions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
| Identification Number: |
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| Keywords: | EXTRACORPOREAL-CIRCULATION; FOLLOW-UP; SYSTEM; Extracorporeal circulation (ECC); Minimised extracorporeal circulation system (MECC); Coronary artery bypass grafting (CABG); EuroScore; High-risk patients | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 66791 |
Web of ScienceAbstract
Background: Coronary artery bypass grafting (CABG) with extracorporeal circulation (ECC) is the gold standard for surgical coronary revascularisation. Recently, minimised extracorporeal circulation system (MECC) has been postulated a safe and advantageous alternative for multi-vessel CABG. Method: Between January 2004 and December 2007, 244 high-risk patients (logistic EuroScore (ES) > 10%) ...
Abstract
Background: Coronary artery bypass grafting (CABG) with extracorporeal circulation (ECC) is the gold standard for surgical coronary revascularisation. Recently, minimised extracorporeal circulation system (MECC) has been postulated a safe and advantageous alternative for multi-vessel CABG. Method: Between January 2004 and December 2007, 244 high-risk patients (logistic EuroScore (ES) > 10%) underwent CABG in our institution. ECC was used in 139 (57%) and MECC in 105 (43%) patients. Demographic data including age (MECC: 73.4 +/- 7.4 years; ECC: 73.3 +/- 6.4 years), ES (MECC: 19.2 +/- 9.8%; ECC: 21.4 +/- 11.9%), left-ventricular ejection fraction (MECC: 45.6 +/- 16.1%; ECC: 43.1 +/- 15.3%), diabetes mellitus (MECC: 14.3%; ECC: 15.1%) and COPD (MECC: 6.7%; ECC: 7.9%) did not differ between the two groups. Preoperative end-stage renal failure was an exclusion criterion. The clinical course and serological/haematological parameters in the ECC and MECC patients were compared in a retrospective manner. Results: Although the numbers of distal anastomoses did not differ between the two groups (MECC: 3.0 +/- 0.9; ECC: 2.9 +/- 0.9), ECC time was significantly shorter in the MECC group (MECC: 96 +/- 33 min; ECC: 120 +/- 50 min, p < 0.01). Creatinine kinase (CK) levels were significantly tower 6 h after surgery in the MECC group (MECC: 681 +/- 1505 U l(-1); ECC: 1086 +/- 1338 U l(-1), p < 0.05) and the need of red blood cell. transfusion was significantly less after MECC surgery (MECC: 3 [range: 1-6]; ECC: 5 [range: 2-9] p < 0.05). Moreover, 30-day mortality was significantly tower in the MECC group as compared to the ECC group (MECC: 12.4%; ECC: 26.6, p < 0.01). Discussion: MECC is a safe alternative for CABG surgery. A lower 30-day mortality, lower transfusion requirements and less renal and myocardial damage encourage the use of MECC systems, especially in high-risk patients. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
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