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ABSTRACT 75
COMPARISON OF OPCAB vs. "ON PUMP CABG"
JASINSKI M, RIDGEWAY D, KNAPIK P, BACHOWSKI R, OLSZOWKA
P, SZURLEJ D, WOS S, SPYT T
Glenfield Hospital, Leicester, UK,
2nd Dept Cardiac Surgery.- Katowice Poland
OBJECTIVE: Comparison of on- and off- bypass CABG in two
surgeons practice
METHODS: 150 consecutive patients undergoing CABG in 1999
were recruited to the study. Perioperative and early in- hospital
postoperative assesment of different strategies of CABG. Three
groups 50 patients each were established: gr. 1- ON PUMP CABG
, gr2 and gr3- OPCAB with different postoperative protocol. They
were comparable with regard to perioperative risk factors (EUROSCORE,
PARSONNET). In particulary, early postoperative period in intensive
care was recorded. including ventilation time (IPPV), inotropes
, blood and FFP transfusion, urine output and overall fluid balance,
drainage, and different laboratory results.
RESULTS: OPCAB patients cp "ON PUMP CABG" presented
with:
higher hemoglobin and platelets levels, lower transfusion rate,
lower inotropes and shorter hospitalization. Different postoperative
strategies of handling with OPCAB had significant influence and
resulted in different IPPV time , urine output, transfusion rate,
hospitalization and postop AF
CONCLUSIONS: Clinical end points of comparison ( mortality,
perioperative MI) were comparable . However, there were distinct
differences in early postoperative period in favor of OPCAB. Within
OPCAB patients diferences are related to early postoperative strategy
what is essential to benefit fully from avoiding CPB
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