In:
Cardiovascular and Thoracic Open, SAGE Publications, Vol. 2 ( 2016-01-01), p. 205555201665079-
Abstract:
The study aimed to assess the influence of the calcification of the ascending aorta on surgical mortality, postoperative stroke, and completeness of coronary revascularization in patients undergoing off-pump coronary artery bypass grafting with graft strategy tailored to its calcification severity. Methods and results: We examined the clinical records of 726 patients who underwent off-pump coronary artery bypass grafting. The age at operation was 71 ± 8 years. Calcification of the ascending aorta was graded as none–mild (less than spotty) in 668 (92.0%), moderate ( 〈 1/4 of circumference) in 26 (3.6%), and severe ( 〉 1/4) in 32 (4.4%) by preoperative non-contrast computed tomography. There were no significant differences in the number of distal anastomoses per patient among the three groups (3.3 ± 1.1, 2.9 ± 1.0, and 3.0 ± 0.9, respectively; p = 0.85). Graft strategy was tailored for each patient. Proximal anastomosis with partial clamp was used in 43.8%, 7.7%, and 3.1%, respectively (p 〈 0.001), while anastomotic devices were used in 6.8%, 30.1%, and 28.1%, respectively (p 〈 0.001). Other patients had aortic no-touch technique. There were four hospital deaths in the none–mild group (0.6%, p = 0.85). Stroke occurred in 1 (0.1%) patient, an aortic no-touch technique patient with none–mild calcification. Complete revascularization was not possible in 1 (0.1%) patient in the severe calcification group. Patency of saphenous vein graft of distal anastomosis was not different among groups. Conclusion: Influence of the calcification of the ascending aorta was minimized by tailoring graft strategy to calcification severity. It can practically abolish postoperative stroke while maintaining coronary revascularization success rates.
Type of Medium:
Online Resource
ISSN:
2055-5520
,
2055-5520
DOI:
10.1177/2055552016650795
Language:
English
Publisher:
SAGE Publications
Publication Date:
2016
detail.hit.zdb_id:
2822182-5
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