Meta-Analysis of Organ Damage After Conversion From Off-Pump Coronary Artery Bypass Procedures

被引:17
作者
Mukherjee, Dayal [1 ]
Rao, Christopher [1 ]
Ibrahim, Michael [1 ]
Ahmed, Kamran [1 ]
Ashrafian, Hutan [1 ]
Protopapas, Aristotle [1 ]
Darzi, Ara [1 ]
Athanasiou, Thanos [1 ]
机构
[1] Imperial Coll London, Dept Biosurg & Surg Technol, London W2 1NY, England
关键词
CARDIOPULMONARY BYPASS; EMERGENCY CONVERSION; SURGERY; MORBIDITY; MORTALITY; OUTCOMES; REVASCULARIZATION; FAILURE; IMPACT; INJURY;
D O I
10.1016/j.athoracsur.2011.05.037
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The relative efficacy of off-pump and on-pump coronary revascularization is uncertain. A complication of off-pump surgery which is rarely considered is intraoperative conversion to cardiopulmonary bypass. Consequently, meta-analysis was performed of studies comparing morbidity after converted and nonconverted off-pump coronary revascularization. There were significant increases in the likelihood of stroke, myocardial injury, bleeding, renal failure, wound infection, intraaortic balloon pump requirement, transfusion, and respiratory and gastrointestinal complications after conversion. The underlying mechanisms need to be urgently elucidated. Prevention and treatment protocols for conversion warrant serious consideration and the risk of conversion may need to be discussed when obtaining informed patient consent. (Ann Thorac Surg 2011;92:755-61) (C) 2011 by The Society of Thoracic Surgeons
引用
收藏
页码:755 / 761
页数:7
相关论文
共 37 条
[21]  
Mujanovic E, 2003, HEART SURG FORUM, V6, P135
[22]   Conversion and Safety in Off-Pump Coronary Artery Bypass: A System Failure That Needs Re-Emphasis [J].
Mukherjee, Dayal ;
Ahmed, Kamran ;
Baig, Kamran ;
Patel, Vanash M. ;
Darzi, Ara ;
Athanasiou, Thanos .
ANNALS OF THORACIC SURGERY, 2011, 91 (02) :630-639
[23]   Central nervous system injury associated with cardiac surgery [J].
Newman, Mark F. ;
Mathew, Joseph P. ;
Grocott, Hilary P. ;
Mackensen, G. Burkhard ;
Monk, Terri ;
Welsh-Bohmer, Kathleen A. ;
Blumenthal, James A. ;
Laskowitz, Daniel T. ;
Mark, Daniel B. .
LANCET, 2006, 368 (9536) :694-703
[24]  
Newman MF, 1996, CIRCULATION, V94, P74
[25]   Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery [J].
Newman, MF ;
Grocott, HP ;
Mathew, JP ;
White, WD ;
Landolfo, K ;
Reves, JG ;
Laskowitz, DT ;
Mark, DB ;
Blumenthal, JA .
STROKE, 2001, 32 (12) :2874-2879
[26]   Emergency conversion to cardiopulmonary bypass during attempted off-pump revascularization results in increased morbidity and mortality [J].
Patel, NC ;
Patel, NU ;
Loulmet, DF ;
McCabe, JC ;
Subramanian, VA .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2004, 128 (05) :655-661
[27]   Impact of off-pump coronary artery bypass surgery on graft patency: Current best available evidence [J].
Raja, Shahzad G. ;
Dreyfus, Gilles D. .
JOURNAL OF CARDIAC SURGERY, 2007, 22 (02) :165-169
[28]   Morbidity and mortality following acute conversion from off-pump to on-pump coronary surgery [J].
Reeves, BC ;
Ascione, R ;
Caputo, M ;
Angelini, GD .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2006, 29 (06) :941-947
[29]   Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting [J].
Reston, JT ;
Tregear, SJ ;
Turkelson, CM .
ANNALS OF THORACIC SURGERY, 2003, 76 (05) :1510-1515
[30]   Adverse cerebral outcomes after coronary bypass surgery [J].
Roach, GW ;
Kanchuger, M ;
Mangano, CM ;
Newman, M ;
Nussmeier, N ;
Wolman, R ;
Aggarwal, A ;
Marschall, K ;
Graham, SH ;
Ley, C ;
Ozanne, G ;
Mangano, DT .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (25) :1857-1863