The role of integrated myocardial management in reoperative coronary surgery

Seminars in Thoracic and Cardiovascular Surgery
C L AthanasuleasG D Buckberg

Abstract

This article identifies the effect of integrated myocardial protection on outcomes after first-time repeat coronary artery bypass grafting (CABG). A consecutive series of 124 repeat CABG procedures were performed between January 1996 and December 1999 with single aortic cross-clamping for all anastomoses and integrated myocardial protection. This included ischemia for heart dissection and distal grafting, and perfusion throughout the remainder of aortic clamping (including warm/cold, substrate/nonsubstrate-enhanced blood cardioplegia, delivered antegrade/retrograde, continuously/intermittently). Mean patient age was 67 +/ - 10 years (median 68) with 61% in New York Heart Association class IV and 23% in class III. Mean ejection fraction (EF) was 45 +/- 10.6% with EF 40% or less in 33% of patients and 30% or less in 20%. An average of 2.5 +/- 0.9 grafts were constructed. Cross-clamp times averaged 72 +/- 22 min and cardiopulmonary bypass time averaged 91 +/- 27 min. The average time from release of cross-clamp it disconnection from cardiopulmonary bypass (CPB) was 10 min. Median postoperative hospital stay was 6 days. hospital mortality was 2.4%, intra-aortic balloon pump (IABP) use 3.2%, stroke 0.8%, atrial fibrillation 11%, and...Continue Reading

References

Jan 1, 1991·The American Journal of Cardiology·H A VerheulA J Dunning
Jan 1, 1995·Journal of Cardiac Surgery·G D BuckbergJ M Robertson
Feb 1, 1995·The Annals of Thoracic Surgery·L A RobinsonT A Galbraith
Jan 1, 1993·The Journal of Cardiovascular Nursing·Z R Brenner
Jan 1, 1997·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·J T ChristensonF Simonet
Dec 8, 2000·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·J Fragata

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.