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KMID : 0613820080180050686
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Journal of Life Science
2008 Volume.18 No. 5 p.686 ~ p.693
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Conversion to Cardiopulmonary Bypass during Attempted Off-pump Coronary Bypass Grafting;An Analysis of Predictors and Clinical Outcomes
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Moon Seong-Min
Kim Chung-Rak
Kim Yun-Tae
Choi Seok-Cheol
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Abstract
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We retrospectively sought to evaluate predictors and clinical outcomes of conversion to cardiopulmonary bypass during attempted off-pump coronary bypass grafting (OPCAP). Predictors and clinical outcomes in 24 patients underwent elective on-pump coronary bypass grafting (ONCAB) (an elective group) were compared with they in 22 patients required conversion from OPCAB to ONCAB (a conversion group). Causes of conversion from off-pump coronary bypass grafting (OPCAB) to ONCAB were hemodynamic instability (45.4%) and cardiac conduction instability (40.9%). The predictors for a conversion group were preoperative myocardial infarction (45.4%), left main coronary artery disease (36.3%) and low left ventricular ejection fraction (31.8%). Mean age, operation time, postoperative arrhythmia incidence and CRP level in a conversion group were higher than those in an elective group. OPCAP in ischemic heart disease requires careful attention, especially in patients with recognized potential preoperative risk factors. Particularly, gentle cardiac manipulation and meticulous myocardial stabilizer should be applied in left ventricular dysfunction patients.
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KEYWORD
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Off-pump coronary bypass grafting, on-pump coronary bypass grafting, hemodynamics, myocardial infarction, left ventricular ejection fraction, arrhythmia
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