Original article: cardiovascularConversion in Off-Pump coronary artery bypass grafting: an analysis of predictors and outcomes
Section snippets
Patients
Data on a total of 4,689 patients were exported from our Society of Thoracic Surgeons (STS) approved database. These data represented the population of all isolated CABG patients operated on by our group of 22 surgeons from January 1, 2000, to June 30, 2002. Patients whose status was listed as “emergent” or “salvage”, who were in cardiogenic shock, or who were being resuscitated were not included in the study, reasoning that they could only be done on-pump. This excluded a total of 151 patients
Results
The overall conversion rate was 3.71% but the rate varied between groups. Surgeons with a high prior volume of OPCAB cases had a rate of 1.85%, which was statistically lower than the rate for low-volume surgeons (7.13%, p < 0.001) or that recorded for moderate-volume surgeons (4.3%, p = 0.02; Table 1).
Overall, patients converted to ONCAB had a significantly higher mortality rate than computer-matched patients whose procedure was initiated as ONCAB (18% versus 2.7%, p < 0.001). Mortality rates
Comment
Several other studies have addressed the incidence of mortality among converted patients, usually comparing the converted patients with patients who were not converted 5, 6, 7, 8, 9. We sought to determine whether patients started off-pump and converted to on-pump fared less well than if their procedure had been initiated as on- pump. For this reason we compared our converted patients with a computer-derived comparable cohort of patients whose procedure was initiated as ONCAB and who had not
References (9)
- et al.
Hemodynamic collapse during off pump coronary artery bypass grafting
Ann Thorac Surg
(2002) - et al.
Off or on bypasswhat is the safety threshold?
Ann Thorac Surg
(1999) - et al.
Conversion to off pump coronary bypass without increased morbidity or change in practice
Ann Thorac Surg
(2002) - et al.
Technical aspects of total revascularization in off pump coronary bypass via sternotomy approach
Ann Thorac Surg
(1999)