On-pump versus off-pump coronary artery bypass grafting in diabetic patients

Biz bu çalışmada diabetik hastalarda, kardiyopulmoner bypass altında yapılan koroner arter bypass greft cerrahisi ile çalışan kalpte yapılan koroner arter bypass greft cerrahisinin kısa dönem sonuçlarını karşılaştırdık.Ocak 2002 ? Aralık 2008 arasında koroner arter bypass cerrahisi geçirmiş 138 diabetik hasta çalışmaya alındı. Bunların 112 (%81,2) tanesi çalışan kalpte koroner bypass uygulanmış hastalardı.Preoperatif özellikler açısından iki grup arasında anlamlı klinik veya istatistiksel fark yoktu. Bununla beraber on-pump grubuyla karşılaştırıldığında off-pump grubunda distal anastomoz sayısı belirgin olarak daha azdı (2.7±0.7 versus 3.1±0,69; P<0.05). Operatif ve postoperatif mortalite oranları benzerdi (off-pump n=3, 2.7%, on-pump n=1, 3.8%; p=0.571). Fakat off-pump gurubunda nörolojik komplikasyonlar belirgin olarak daha azdı (0.9% versus 15.3%; p=0.004). Ayrıca, off-pump grubunda kan transfüzyonu ihtiyacı (p < 0.05) ve hastanede kalış süresi (p < 0.05) belirgin olarak daha azdı.Her iki grup arasında, hastane içinde ki mortalite açısından anlamlı fark olmamasına rağmen, on-pump koroner cerrahi ile karşılaştırıldığında, diabetik hastalarda off-pump koroner arter cerrahisi, postoperatif morbidite ve hastanede kalış süresi açısından önemli bir avantaj sağlar.We evaluated our outcomes in diabetic patients to compare the effect of off-pump with on-pump coronary revascularization.Between January 2002 and December 2008, 138 consecutive diabetic patients underwent isolated coronary artery bypass grafting. A total of 112 (81,2%) of these patients had off-pump coronary procedures.There were no significant clinical or statistical differences between the two groups for any prognostic variable. However, off-pump patients received significantly fewer distal anastomoses than the on-pump group (2.7±0.7 versus 3.1±0,69; P<0.05). There was no difference in operative and postoperative mortality (off-pump n=3, 2.7%, on-pump n=1, 3.8%; p=0.571), but the off-pump group had significantly fewer neurological complications (0.9% versus 15.3%; p=0.004). Off-pump patients also required less blood transfusion (p < 0.05) and had shorter lengths of stay (p < 0.05).Off-pump coronary operation in diabetic patients significantly reduced postoperative morbidity and length of stay compared with on-pump coronary operation, although no in-hospital survival difference was noted between the two groups

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

<div><p>Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.</p></div