engleski

AORTA "NO-TOUCH" VS STANDARD APPROACH FOR OFF-PUMP TOTAL ARTERIAL REVASCULARIZATION

Objective: We sought to compare the early clinical outcome of two surgical approaches for off-pump total arterial revascularization. Methods: From 2/1998 to 12/2004, 279 patients underwent off-pump total arterial revascularization utilizing both IMA's and radial arteries. Standard approach with proximal aortic anastomoses was used in 179 patients (group A), and aorta "no-touch" technique was used in 100 patients (group B). Fourteen percent of patients in group A had left-main stenosis vs 24% in group B (p=0.031). There were no significant differences in other demographic characteristics between groups preoperativelly, including the risk profile. Median EuroSCORE was 2 in both groups (p=0.481). Results: The number of distal anastomoses created was 2, 3&plusmn ; 0, 5 in group A vs 2, 6&plusmn ; 0, 7 in group B (p<0.001). One patient suffered a perioperative stroke in group A and 1 on group B (p=1.000). Five patients (3%) suffered a perioperative MI in group A and 3 (3%) in group B (p=0.716). Overall early mortality was 2.8% in group A vs 5% in group B (p=0.338). Conclusions: Aorta "no-touch" technique is as safe as standard methods for total arterial off-pump revascularization. Further analysis is neccessary to investigate whether relatively high mortality rates in both groups should be attributed to graft choices, surgical technique or postoperative management.

aorto "no-touch"; off-pump; cardiac surgery

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