In:
Cardiovascular and Thoracic Open, SAGE Publications, Vol. 2 ( 2016-01-01), p. 205555201665079-
Kurzfassung:
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.
Materialart:
Online-Ressource
ISSN:
2055-5520
,
2055-5520
DOI:
10.1177/2055552016650795
Sprache:
Englisch
Verlag:
SAGE Publications
Publikationsdatum:
2016
ZDB Id:
2822182-5
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