Combined coronary artery bypass grafting and aortic valve replacement with minimal extracorporeal closed circuit circulation versus standard cardiopulmonary bypass

被引:24
|
作者
Yilmaz, Alaadin [1 ]
Sjatskig, Jelena [1 ]
van Boven, Wim J. [1 ]
Waanders, Frans G. [2 ]
Kelder, Johannes C. [3 ]
Sonker, Uday [1 ]
Kloppenburg, Geoffrey T. L. [1 ]
机构
[1] St Antonius Hosp, Dept Cardiothorac Surg, NL-3430 EM Nieuwegein, Netherlands
[2] St Antonius Hosp, Dept Clin Perfus, NL-3430 EM Nieuwegein, Netherlands
[3] St Antonius Hosp, Dept Cardiol, NL-3430 EM Nieuwegein, Netherlands
关键词
Aortic valve replacement; Minimal extracorporeal closed circuit; Coronary artery bypass grafting; INFLAMMATORY RESPONSE; SYSTEM;
D O I
10.1510/icvts.2010.241943
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Isolated aortic valve replacement (AVR) or coronary artery bypass grafting (CABG) using minimized extracorporeal circulation (MECC) has been shown to have less deleterious effects than standard cardiopulmonary bypass (CPB). In this prospective cohort study, we evaluated and compared clinical results of combined AVR with CABG using MECC. We prospectively collected preoperative, intraoperative, postoperative and follow-up data of 65 patients who underwent combined AVR with CABG using MECC and compared these with 135 patients undergoing combined AVR with CABG using standard CPB. No significant differences were seen in patients demographic characteristics or intraoperative data. Patients in the MECC group experienced a smaller preoperative haemoglobin drop (4.5 +/- 0.8 g/dl vs. 5.0 +/- 0.5 g/dl, P=0.002) resulting in higher haemoglobin at discharge (11.3 +/- 1.3 g/dl vs. 10.8 +/- 1.1 g/dl, P=0.03). They had decreased blood products requirements (P=0.004) compared to patients in the standard CPB group. No differences were noted in pulmonary complications, neurological events or mortality. We present for the first time data showing that combined AVR with CABG using MECC is feasible and provides better clinical results compared to standard CPB with regard to blood products requirements, without compromising operative morbidity or mortality. (C) 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
引用
收藏
页码:754 / 757
页数:4
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