Author:
Wu Zhen,Liu Changcheng,Fang Ying,Wei Hua,Gu Chengxiong
Abstract
Abstract
Background
The efficacy of intra-aortic balloon pump (IABP) has been proven in high-risk patients undergoing coronary artery bypass grafting (CABG). However, data on the timing and benefits of IABP support in diffuse coronary artery disease after CABG combined with coronary endarterectomy (CE) remain scarce. This retrospective study assessed the effect of intraoperative or postoperative IABP on 30-day outcomes of off-pump CABG+CE.
Methods
From January 2012 to December 2018, 546 patients undergone off-pump CABG+CE were divided into control group (n = 437) and IABP group (n = 109). Risk factors for 30-day outcomes were evaluated. Subgroup analysis from IABP group was conducted to identify the effect of timing IABP on 30-day outcomes.
Results
CE on left anterior descending branch of coronary artery (LAD) (OR = 3.079, 95% CI 1.077–8.805, P = 0.036), CE with≥2 vessels (OR = 9.123, 95% CI 3.179–26.033, P < 0.001) and length of atherosclerotic plaque ≥3 cm (OR = 16.017, 95% CI 5.941–43.183, P < 0.001) were independent risk factors for postoperative acute myocardial infarction (AMI) and 30-day mortality. Comparing with intraoperative IABP support, postoperative IABP support (OR = 3.987, 95% CI1.194–13.317, P = 0.025) was closely associated with postoperative AMI and 30-day mortality.
Conclusions
For patients undergone off-pump CABG and extensive CE (CE on LAD, CE ≥2 vessels and length of atherosclerotic plaque ≥3 cm), intraoperative IABP support may improve 30-day outcomes.
Funder
Foundation for Innovative Research Groups of the National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine,Surgery,Pulmonary and Respiratory Medicine
Reference25 articles.
1. Sabzi F, Asadmobini A, Rezaei M. Comparing short and long term survival of patients undergoing off pump coronary artery bypass graft with and without coronary endarterectomy. Indian Heart J. 2017;69:646–50.
2. Qiu Z, Auchoybur Merveesh L, Xu Y, Jiang Y, Wang L, Xu M, et al. The midterm results of coronary endarterectomy in patients with diffuse coronary artery disease. J Cardiothorac Surg. 2018;13:90.
3. Lee JH, Lim C, Kim JS, Park KH. Early and mid-term results of coronary endarterectomy: influence of cardiopulmonary bypass and surgical techniques. Cardiol J. 2017;24:242–9.
4. Nardi P, Russo M, Saitto G, Bovio E, Vacirca SR, Bassano C, et al. Coronary endarterectomy: an old tool for patients currently operated on with coronary artery bypass grafting. Long-term results, risk factor analysis. Kardiochir Torakochirurgia Pol. 2018;15:219–26.
5. Uchimuro T, Fukui T, Mihara W, Takanashi S. Acute thrombosis after endarterectomy of stented left anterior descending artery. Interact Cardiovasc Thorac Surg. 2009;8:663–5.
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献