Abstract

MONTERO, HUGO et al. Cirugía de revascularización miocárdica sin circulación extracorpórea: ¿Qué ocurre con la conversión de emergencia?. Rev.Urug.Cardiol. [online]. 2008, vol.23, n.1, pp.15-20. ISSN 1688-0420.

SUMMARY Objective: to compare the results and evolution between emergency converted off pump coronary artery surgery (OPCAS), OPCAS and on pump coronary artery revascularization. Material and methods: this is a cohort study which included 3.738 patients who underwent coronary artery revascularization at the Instituto Nacional de Cirugía Cardíaca (INCC) between January 2002 and December 2006; 1.486 were coordinated to be operated off pump and 2.252 on pump. Among OPCAS patients 39 patients required emergency conversion (group I); they were compared with 2.252 patients with on pump CABG (group II) and 1.147 OPCAS patients (group III). Predisposing factors associated with conversion were investigated. Postoperative variables were compared between groups. Results: no predisposing factors to conversion were found, except higher incidence of cerebrovascular disease in group I. Evolution: longer ICU stay*, assisted mechanical ventilation*, stroke (p=NS), atrial fibrillation*, acute myocardial infarction*, hemodialysis*, greater need for inotropic support* and intraaortic ballon contrapulsation* was found in group I (*=p<0,05). EuroSCORE mortality: 7,7% (group I) 5,9% (group II) 5,7% (group III), (NS), Operative mortality: 10,3% (group I), 4,8% (group II), 3,5%, (group III)*. Operative mortality by intention to treat was: 4,8% for on pump revascularization vs 3.7% for off pump coronary artery revascularization (converted + non converted) (p=NS). Conclusion: OPCAS that requires emergency conversion has greater morbimortality, nonetheless it does not negatively affect OPCAS benefits, regarding operative mortality, when intention to treat analysis is considered

Keywords : MYOCARDIAL REVASCULARIZATION; CORONARY VESSELS-surgery; OFF-PUMP CORONARY SURGERY.

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