Does the off-pump coronary artery bypass grafting affect the outcome in ischemic cardiomyopathy?

Mahmoud, Ashraf Fawzy; Adel, Mohamed; Ali, Hosam Fathy; Alkady, Hesham

doi:10.1016/j.jescts.2017.01.002

Cited by 3 publications

(6 citation statements)

References 35 publications

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“…The mean EF was 30% in the two groups. It is comparable to the mean EF in other studies; Li S et al [10] for example, reported EF of 37% in the two groups; while Mahmoud et al [8] reported EF of 30% in both groups, as in the current study.…”

Section: Discussionsupporting

confidence: 90%

“…There was no significant difference in mean early post-operative EF between on and off-pump patients, unlike other studies like Mahmoud et al [8] that was [28.1±5.2. %] in the on-pump group and [31.4±11%] in the off-pump group and Li S et al [10] that was [29.2±6.5%] in the on-pump group and [ 33.6±7.12%] in the off-pump group.…”

Section: Discussioncontrasting

confidence: 72%

“…In the on-pump group, there were [9] patients who required dialysis [30%], and they were among the group of [13] patients who were diagnosed as postoperative renal dysfunction, while in the offpump group [2] patients required dialysis [6.76%] and they were among the [3] patients who had postoperative renal dysfunction. Comparing that to other studies as following Mahmoud et al [8] that shows [27%] of patients in pump group who had impaired postoperative renal dysfunction and [7%] of those had needed renal dialysis while in the offpump group [6%] of patients had impaired postoperative renal functions and [2.3%] of those needed hemodialysis and also Arslan et al [20] that shows [18.75 %] of patients in the pump group who needed renal dialysis while in the off-pump group [2.77%] only needed renal dialysis.…”

Section: Discussionsupporting

confidence: 64%

“…Although the EF is a good indicator for the outcome of surgery; yet some patients with no increase in the EF have still better follow up; low EF is not an obstacle to surgery, especially with the new advents in the anesthetic, surgical techniques, medications, machines and advanced technology in ICU [8] In patients with low EF, OPCAB was associated with a significant reduction of reoperation, perioperative transfusion, prolonged ICU, and hospital stay. These results are not different than the largest retrospective study of OPCAB in patients with low cardiac function, which showed the clinical impact of OPCAB [11] , but that was not the case with the large randomized controlled trials [the ROOBY and CORONARY trials] did not show improved mortality in the OPCAB groups.…”

Section: Discussionmentioning

confidence: 99%

“…This study's younger mean age may be due to higher risk factors, especially smoking, dyslipidemia, and sedentary lifestyle, which are common in most developing countries, including Egypt. For example, Mahmoud et al [8] reported that, in the on-pump group, 56 % of patients had diabetes, 70% were hypertensive, 48.5% had a history of myocardial infarction [MI], 65.5% were smokers, and 48.5% had dyslipidemia. In the OPCAB group, 51.5% of candidates had diabetes, 68% were hypertensive, 41.5 % had a history of myocardial infarction, 70 % were smokers, and 41.5 % had dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

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OFF PUMP VERSUS ON PUMP CORONARY ARTERY BYPASS SURGERY in ISCHEMIC HEART DISEASE PATIENTS with IMPAIRED CONTRACTILITY and RENAL DYSFUNCTION ;ACOPARATIVE STUDY.

Abdelsamad¹,

Hassan

Sharaa

et al. 2020

International Journal of Medical Arts

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Background: Coronary artery bypass surgery using cardiopulmonary bypass [CPB] carries the risk of renal impairment, which cannot be attributed to a single factor. This study compared the off-pump technique with the on-pump technique on kidney function in ischemic heart disease patients. Aim of the work:The study aimed to compare off-pump with on-pump technique on kidney and heart functions in patients with renal impairment with no need for dialysis but with impaired Ejection fraction [EF]. Patients and methods:This prospective non-randomized study included 60 patients who presented with symptoms of ischemic heart disease and subsequently underwent myocardial revascularization with preoperative serum creatinine levels between 1.6 to 2.5 mg/dl and EF below 45%. Patients were as following: Group A patients [on-pump]: included those who underwent surgery on cardiopulmonary bypass. Group B patients [off-pump]: included those who underwent off-pump surgery. Both groups were compared in terms of renal impairment markers and needed for dialysis and early postoperative outcome.Results: Renal impairment needs management by dialysis was developed in nine patients [30%] in the pump group [group I] and two patients [7.67%] in the off-pump group, with a significant difference. Group [I] showed a significant increase of transfused blood, blood urea nitrogen, serum creatinine, acute kidney injury [13 patients], reopening for bleeding, postoperative renal impairment, need for renal dialysis, total intensive care unit stay, and the total duration of hospital admission. However, it had a significant reduction in hemoglobin and creatinine clearance. Conclusion:Off-pump coronary revascularization offers a better kidney function preservation and has a decreased risk for kidney dysfunction in patients with renal impairment without dialysis compared with coronary revascularization with cardiopulmonary bypass.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 72%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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OFF PUMP VERSUS ON PUMP CORONARY ARTERY BYPASS SURGERY in ISCHEMIC HEART DISEASE PATIENTS with IMPAIRED CONTRACTILITY and RENAL DYSFUNCTION ;ACOPARATIVE STUDY.

Abdelsamad¹,

Hassan

Sharaa

et al. 2020

International Journal of Medical Arts

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On-pump beating versus arrested heart (conventional) revascularization in severe left ventricular dysfunction

Farag

2017

Journal of the Egyptian Society of Cardio-Thoracic Surgery

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Effect of creatine kinase isoenzyme (CK-MB) on early prognosis after off-pump coronary artery bypass grafting.

Zhou,

Wang,

Wang

et al. 2023

Investigación Clínica

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This study aimed to analyze the effect of elevated creatine ki-nase isozyme levels on early prognosis after off-pump coronary artery bypass (OPCAB) grafting. Based on the levels of creatine kinase isoenzyme (CK-MB), 116 patients were divided into two groups: one with a mild increase (n=85) and another group with a severe increase (n=31) in the enzyme. Clinical data, changes in CK-MB levels at 12, 24, and 48 hours after surgery, changes in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVESD) before surgery, and seven days and three months after surgery were measured, and recorded. Also, the blood flow of the bridging vessel, vascular resistance, the diameter of the anterior descending branch, and the diameter of the distal target vessel were recorded during the operation (> 1.5 mm). A decrease in the level of LVEDD was recorded in both groups after the operation compared to the levels before. However, in the group with a mild increase in CK-MB, the LVEF after the operation increased compared to before the operation (p<0.05). The occurrence of angina pectoris 24 hours before surgery, high vas-cular resistance during surgery, and diameter of distal target vessel > 1.5 mm were related factors affecting the increase of CK-MB after surgery. The ratio of these factors was higher in the severe increase group than in the mild increase group (p<0.05). An increase in myocardial enzymes causes a slow recovery of myocardial function, so it can be used as a critical biological index to reflect the prognosis of patients.

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Does the off-pump coronary artery bypass grafting affect the outcome in ischemic cardiomyopathy?

Cited by 3 publications

References 35 publications

OFF PUMP VERSUS ON PUMP CORONARY ARTERY BYPASS SURGERY in ISCHEMIC HEART DISEASE PATIENTS with IMPAIRED CONTRACTILITY and RENAL DYSFUNCTION ;ACOPARATIVE STUDY.

OFF PUMP VERSUS ON PUMP CORONARY ARTERY BYPASS SURGERY in ISCHEMIC HEART DISEASE PATIENTS with IMPAIRED CONTRACTILITY and RENAL DYSFUNCTION ;ACOPARATIVE STUDY.

On-pump beating versus arrested heart (conventional) revascularization in severe left ventricular dysfunction

Effect of creatine kinase isoenzyme (CK-MB) on early prognosis after off-pump coronary artery bypass grafting.

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