Early Postoperative Outcome of Off-Pump Coronary Artery Bypass Grafting: A Report from the Highest-Volume Center in Japan

Kuroda, Kishio; Kato, Tomoko S.; Kuwaki, Kenji; Kajimoto, Kan; Lee, Seitetsu L.; Yamamoto, Taira; Amano, Atsushi

doi:10.5761/atcs.oa.15-00152

Cited by 5 publications

(6 citation statements)

References 33 publications

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“…However, OPCAB does not accompany these kinds of complications and can provide pulsatile circulation to every organ all through the operation. Therefore, the choice of this mode for high-risk patients who have several comorbidities, such as a history of cerebrovascular disease or LV dysfunction, would lead to a risk reduction [Christakis 1989;Kuroda 2016;Appoo 2004;Topkara 2005;Pieri 2016].…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports emphasized that the operative mortality rate after CABG for patients with low EF were high [Pieri 2016;Jarral 2011], but several recent reports from Japan showed more favorable outcome has been achieved with the sophistication of the strategy of OPCAB even for this cohort (0.5-2.5%) [Kuroda 2016;Fukui 2014;Ueki 2016]. Kuss et al emphasized the superiority of OPCAB to on-pump CABG in hard endpoints with their review and meta-analysis of propensity score [Kuss 2010].…”

Section: Discussionmentioning

confidence: 99%

“…Another hurdle is the risk of emergence of critical arrhythmia requiring pump conversion. Kuroda et al recently reported the detailed information of patients who experienced the unplanned pump conversion, and major reasons were the elevation of pulmonary artery pressure and arrhythmia [Kuroda 2016]. Many reports show how important it is to use several mechanical devices to complete this maneuver safely for high-risk groups [Craver 2001;Vohra 2006].…”

Section: Discussionmentioning

confidence: 99%

“…Historically, left ventricular (LV) dysfunction has been regarded as a strong influencer for operative mortality [Christakis 1989;Kuroda 2016;Appoo 2004;Topkara 2005;Pieri 2016] because the usage of cardiopulmonary bypass and period of arrested heart may lead to the deterioration of the recovery of LV function in the early phase of the postoperative period. Previous studies have reported operative mortality rate after coronary artery bypass grafting (CABG) for those with LV dysfunction reached around 5% [Pieri 2016].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Left Ventricular Dysfunction on The Early and Midterm Outcome in The Patients Undergoing Off Pump Coronary Artery Bypass Grafting Assessed by Propensity Matched Score Analysis

Shirasaka¹,

Arayawudhikul²,

Tantraworasin³

et al. 2022

HSF

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Background: It still remains unclear the depth of influence of left ventricular dysfunction on the recovery of patients’ physical conditions in the early and midterm period following off-pump coronary artery bypass grafting (OPCAB). Methods: From April 2011 to May 2018, 851 patients underwent OPCAB in our center. All were grouped into two groups: Those whose ejection fraction (EF) was under 35% were defined as the Low EF group (N = 158) and those who maintained EF over 35% were defined as the Faired EF group (N = 693). Preoperatively, there was significant difference in NYHA class (P < 0.001), CCS class (P = 0.038), level of creatinine (P < 0.001), and rate of establishment of IABP (P < 0.001). Results: Regarding all-cause death in the early postoperative period, low EF was a not a risk factor in patients (P = 0.52) or in the matched cohort (P = 0.398); however, in the midterm, it was a significant risk factor in patients (HR 2.07, P = 0.016) and in the matched cohort (HR 2.72, P = 0.029). Overall survival at 5 years in the Low EF group was significantly inferior to that of the Faired EF group in all (67.4±4.1% and 86.1±2.9%, P = 0.001) and in the matched cohort (66.5±6.4% vs. 86.5±4.5%, P = 0.008). Conclusion: OPCAB seems beneficial for patients with LV dysfunction considering the early outcome, however, low EF is a significant risk factor for overall death in the midterm period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Influence of Left Ventricular Dysfunction on The Early and Midterm Outcome in The Patients Undergoing Off Pump Coronary Artery Bypass Grafting Assessed by Propensity Matched Score Analysis

Shirasaka¹,

Arayawudhikul²,

Tantraworasin³

et al. 2022

HSF

View full text Add to dashboard Cite

show abstract

“…Unlike the United States, where there has been a decline in the overall use of OPCAB (17% in 2012 v 23% in 2002), the proportion of OPCAB among total CABG cases in Japan has exceeded 60% based on reports from the Japanese Associate for Coronary Artery Surgery (65% in 2013). 21 The widespread use of OPCAB in Japan makes the findings of this study particularly relevant to regions where this is the predominant technique for coronary revascularization. It seems intuitive that the cardiac acrobatics imposed by lifting, compression, and rotation during OPCAB would affect cardiac structures such as the atrioventricular valves, leading to valvular insufficiency, or what might be aptly referred to as distortional MR. Quantitative 3D imaging and analysis have given us a means to characterize not only pathologic annular geometry, but also the effects of physical deformation on annular dynamics, as has been nicely illustrated in the highlighted study.…”

mentioning

confidence: 91%