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Early Outcome of On-pump Versus Off-pump Elective Surgical Revascularization in Patients with Prior ST-Segment Elevation Myocardial Infarction.
Jahan, S I; Hassan, M K; Khan, A S M; Islam, M Z; Hasan, M K; Haque, A M Z; Rushel, K S S; Alam, A K M; Sium, A H; Sazzad, F.
Afiliación
  • Jahan SI; Dr Sakila Israt Jahan, Assistant Professor, Department of Cardiac Surgery, National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh; E-mail: sakilasathi1986@gmail.com.
Mymensingh Med J ; 33(2): 516-525, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38557535
ABSTRACT
Coronary artery bypass graft surgery (CABG) is a proven treatment for coronary artery disease. History of a ST-elevation myocardial infarction (STEMI) is considered an independent risk factor for CABG irrespective of timing for an emergency or elective surgery. Patients with STEMI are candidates for both On-pump and Off-pump CABG procedures. This paper discusses the possible best option for elective surgical revascularization in patients with prior STEMI. This prospective clinical trial of 60 eligible patients with prior STEMI was conducted in a Tertiary Care Hospital from April 2018 to March 2019. Among them, 30 patients underwent off-pump (Group A) and 30 patients underwent on-pump (Group B) CABG procedures. Outcomes between both groups were observed from surgery to 1 month postoperatively. Data was analysed by the software statistical program for social science (SPSS 25.0 Inc). The surgery was successful in both groups of patients. Differences were observed by mean number of grafts per patient (2.77±0.43 vs. 3.10±0.71) and duration of operation (4.41±0.35 hours vs. 5.71±0.48 hours). An improvement in Left Ventricular Ejection Fraction (LVEF %) was observed in both groups postoperatively (17.98% vs. 10.98%) and the postoperative LVEF% at different time points were found statistically significant (p<0.05) over preoperative LVEF%. Multivariable stepwise logistic regression analysis correlated on-pump CABG with prolonged need for ionotropic support, need for blood transfusion, longer hospital stay and less improvement in LVEF%. The study supports the Off-pump CABG as a better surgical option over on-pump CABG in patients with prior STEMI.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Infarto del Miocardio con Elevación del ST Límite: Humans Idioma: En Revista: Mymensingh Med J Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Bangladesh
Buscar en Google
Añadir a Mi BVS
Imprimir
XML
PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Infarto del Miocardio con Elevación del ST Límite: Humans Idioma: En Revista: Mymensingh Med J Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Bangladesh