Correlation of preoperative factors, severity of disease, type of oxygenator and perfusion times with mortality and morbidity of coronary bypass

Abstract

Previous studies have related preoperative status and severity of disease to the outcome of coronary artery bypass surgery. Although increased perfusion and clamp times increase the risk of cardiac surgical procedures, the importance of these factors in relation to the patient's preoperative condition and the severity of disease has not previously been determined. In this study of 1078 patients, we examined the correlation between the patient's preoperative condition, the severity of coronary disease, and duration of perfusion and clamp time, and the type of oxygenator used with the mortality and morbidity associated with coronary artery bypass grafting. One-way analysis of variance and multiple correlation analysis showed that perfusion time, clamp time and nonclamp perfusion time correlated with mortality, perioperative infarction, the use of intra-aortic balloon pump, stroke, renal failure, pulmonary failure, infection, and leg wound complications (p < 0.05). Perfusion time, clamp time and nonclamp perfusion time did not correlate with postoperative bleeding or sternal wound complications. Nonclamp perfusion time correlated more strongly than any other factor with mortality, perioperative infarction, the use of intra-aortic balloon pump, renal failure, pulmonary failure and infection (p < 0.05). Clamp time correlated more than any other factor with the development of leg-wound complications (p < 0.05). The use of a bubble rather than a membrane oxygenator was significantly related to mortality, stroke, infection and leg wound complications by one-way analysis of variance (p < 0.05). The results of this study suggest that increased duration of nonclamp perfusion time and clamp time, combined with the use of a bubble oxygenator, increases the risk of mortality and morbidity for coronary artery bypass grafting.